Article Text

Download PDFPDF
Palliative care for intestinal obstruction in recurrent ovarian cancer: a multivariate analysis
  1. G. MANGILI*,
  2. G. ALETTI*,
  3. L. FRIGERIO*,
  4. M. FRANCHI,
  5. N. PANACCI*,
  6. R. VIGANÒ*,
  7. P. DE MARZI*,
  8. F. ZANETTO* and
  9. A. FERRARI*
  1. *Division of Gynecology and Obstetrics, University “Vita e Salute,” S. Raffaele Hospital, Milano, Italy
  2. †Division of Obstetrics and Gynecology, University of Varese, Varese, Italy
  1. Address correspondence and reprint requests to: Luigi Frigerio, MD, Division of Obstetrics and Gynecology, Ospedali Riuniti di Bergamo, Largo Barozzi 1, Bergamo, Italy. Email: lfrigerio{at}


Bowel obstruction is the most common complication in patients with ovarian cancer. Management of this situation is controversial. The aim of our retrospective study was to determine the best approach for managing bowel obstruction in recurrent ovarian cancer. A retrospective analysis of data on 47 patients with intestinal obstruction by ovarian cancer was performed. Twenty-seven patients were submitted to surgery, with 21 intestinal procedures performed, 2 gastrostomy tubes placed, and 4 patients deemed inoperable. Twenty patients were managed medically with Octreotide (mean dosage of 0.48 mg/day), of which 1 patient required a nasogastric tube. Age, performance status, diagnosis of tumor to occlusion time, obstruction site, previous chemotherapy or radiotherapy, presence of ascites, or palpable masses were the variables analyzed. Student's t-test and Pearson chi-square test were used to compare the two different groups of treatment (surgical vs medical therapy). Disease-free-survival curves were plotted according to the Kaplan–Meier method and analyzed by the log-rank test. Cox's proportional hazards model was used for multivariate analysis. Values less than or equal to 0.05 were considered significant. The mean age of the patients was 58.7 years. Perioperative mortality and morbidity were both 22%. All patients died with minimal distress. Performance status results were significantly different between the patients submitted to surgery and patients treated with Octreotide (P = 0.03). No significant differences were found in the other variables analyzed. In multivariate analysis, only type of treatment emerges as a strong predictor of poor outcome (P < 0.001). Both surgery and Octreotide therapy are able to control distressing symptoms in end-stage ovarian cancer. Survival was significantly longer in the surgical group, and surgical palliation should be considered first in patients with good performance status.

  • bowel obstruction
  • intestinal surgery
  • Octreotide
  • palliative care
  • recurrent ovarian cancer

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.