Cancer Management and Research (Aug 2020)

Surgical and Conservative Management of Malignant Bowel Obstruction: Outcome and Prognostic Factors

  • Yu K,
  • Liu L,
  • Zhang X,
  • Zhang Z,
  • Rao B,
  • Chen Y,
  • Li S,
  • Shi H

Journal volume & issue
Vol. Volume 12
pp. 7797 – 7803

Abstract

Read online

Kaiying Yu,1– 3,* Lihui Liu,3,4,* Xiaowei Zhang,1– 3 Zhanzhi Zhang,1– 3 Benqiang Rao,1– 3 Yongbing Chen,1– 3 Suyun Li,2,3 Hanping Shi1– 3 1Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, People’s Republic of China; 2Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, People’s Republic of China; 3Ninth School of Clinical Medicine, Peking University, Beijing 100038, People’s Republic of China; 4Department of Nursing, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hanping ShiDepartment of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10th Tieyi Road, Haidian District, Beijing 100038, People’s Republic of ChinaTel +86-13802741263Fax +86-010-63926519Email [email protected]: Malignant bowel obstruction (MBO) is a common problem in late-stage cancer patients. Many factors are suggested to be associated with the prognosis of MBO. The current investigation was designed to explore the factors associated with the prognosis of conservative and surgery treatment in one single institution.Patients and Methods: Sixty-four patients of MBO were recruited into the study. Demographic and clinical data including gender, age, primary cancer, radiological and laboratory examinations, and nutritional and pain index scaling were extracted for further analysis. Kaplan–Meier analysis and logistic regression analysis were used to compare the prognosis and detect significant factors.Results: Of the 64 patients, there is no statistical difference in baseline features between conservative and surgical group. However, the length of stay, total medical costs, re-admission interval, and re-admission rate are statistically significant. There is no significance in Kaplan–Meier log rank test for median survival time, though the overall survival time in the conservative group is longer than that of the surgery group. Logistic regression analysis has found that prior chemotherapy is a significant predictor for final survival outcome.Conclusion: The election of surgery might not improve the overall survival time. Non-surgical procedures, especially chemotherapy, might be preferable for MBO patients.Keywords: malignant bowel obstruction, surgical treatment, conservative management, prognosis, survival

Keywords