Introduction/Background Therapy options by malignant intestinal obstruction (MIO) in relapsed ovarian cancer (rOC) are associated with high mortality and morbidity rates, which poses a great challenge in deciding which therapy option should be chosen. Our aim was to evaluate clinical and surgical outcomes of pts with MIO in rOC, who were operated directly, or after failure of conservative treatment in the further course of disease.

Methodology It was a descriptive analysis of pts with MIO and rOC admitted to KEM (Germany) in 2012–2022. Data were extracted from the prospectively running data base of our clinic, missing data were elucidated by chart review.

Results 22 pts were included. 20 pts had HGSOC. 18 pts(82%) represented with nausea, vomiting, abdominal pain; 4 pts(18%) – with acute abdomen. At the time of diagnosis of MIO, 8 pts(36%) presented with the 1 st relapse simultaneously; 14 pts(64%) were in the 2nd or further line therapy with 6/14 pts(43%) also having a relapse. 8 pts(36%) were primarily treated conservatively, 14 pts(64%) underwent direct surgery. The median time of conservative therapy was 19.5 days (range 9–63 days). After no improvement or worsening of symptoms 7 pts were operated. 5/7 pts had a major complication requiring another abdominal surgery, compared to 3/14 pts who were primarily operated. The mean hospital stay was 49.6 days (conservative therapy, range 10–96) vs. 27.2 days (directly operated, range 10–65)(p=0.028). Finally, 17 pts(77%) were discharged, 5 pts(23%) were transferred to palliative care unit. Median overall survival (OS) for all pts was 12 months (range 1–72 months) with OS of 48 months for primarily operated vs. 12 months treated primarily conservatively (p=0.769), 30-day mortality was 4.5%.

Conclusion Secondary surgery after failure of conservative management of MIO is associated with increased complications, longer hospital stay and frequent referral to palliative care.

Disclosures Authors have no conflicts of interest to declare regarding the submitted work.