Inoperable Bowel Obstruction in Ovarian Cancer: Prevalence, Impact and Management Challenges

Abstract

Eduardo Gonzalez-Ochoa,1 Husam A Alqaisi,1 Gita Bhat,1 Nazlin Jivraj,1 Stephanie Lheureux1,2 1Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; 2Department of Medicine, University of Toronto, Toronto, Ontario, CanadaCorrespondence: Stephanie Lheureux, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada, Tel [phone], Email [email protected]: Malignant bowel obstruction (MBO) is one of the most severe complications in patients with advanced ovarian cancer, with an estimated incidence up to 50%. Its presence is related to poor prognosis and a life expectancy measured in weeks for inoperable cases. Symptoms are usually difficult to manage and often require hospitalization, which carries a high burden on patients, caregivers and the healthcare system. Management is complex and requires a multidisciplinary approach to improve clinical outcomes. Patients with inoperable MBO are treated medically with analgesics, antiemetics, steroids and antisecretory agents. Parenteral nutrition and gut decompression with nasogastric tube, venting gastrostomy or stenting may be used as supportive therapy. Treatment decision-making is challenging and often based on clinical expertise and local policies, with lack of high-quality evidence to optimally standardize management. The present review summarizes current literature on inoperable bowel obstruction in ovarian cancer, focusing on epidemiology, prognostic factors, clinical outcomes, medical management, multidisciplinary interventions and quality of life.Keywords: bowel obstruction, inoperable, ovarian cancer, medical management, multidisciplinary

Keywords

• bowel obstruction
• inoperable
• ovarian cancer
• medical management
• multidisciplinary.