PT - JOURNAL ARTICLE AU - Marcus Bahra AU - Christina Fotopoulou AU - Elena Ioana Braicu AU - Sara-Lea Kwee AU - Marc Kuhberg AU - Rolf Richter AU - Klaus Pietzner AU - Aarne Feldheiser AU - Sven Christian Schmidt AU - Jalid Sehouli TI - Salvage Surgery Due To Bowel Obstruction in Advanced or Relapsed Ovarian Cancer Resulting in Short Bowel Syndrome and Long-Life Total Parenteral Nutrition: Surgical and Clinical Outcome AID - 10.1097/IGC.0b013e31829f81ca DP - 2013 Oct 01 TA - International Journal of Gynecologic Cancer PG - 1495--1500 VI - 23 IP - 8 4099 - http://ijgc.bmj.com/content/23/8/1495.short 4100 - http://ijgc.bmj.com/content/23/8/1495.full SO - Int J Gynecol Cancer2013 Oct 01; 23 AB - Objective Salvage surgery for patients with highly advanced or relapsed epithelial ovarian cancer (EOC) complicated by bowel obstruction and resulting in short bowel syndrome (SBS) constitutes a therapeutic dilemma. Our aim was to evaluate surgical and clinical outcome in these highly palliative situations.Methods We evaluated all patients with EOC who underwent salvage extraperitoneal en bloc intestinal resection with terminal ileostomy or jejunostomy resulting in SBS and total parenteral nutrition owing to bowel obstruction between May 2003 and January 2012 in our institution.Results Thirty-seven patients were identified (median age, 58 years; range, 22–71 years), 3 (8.1%) with primary and 34 (91.6%) with relapsed EOC. Five patients (13.5%) were platinum sensitive. Median residual intestinal length was 70 cm (range, 10–180 cm); 21 patients (56.8%) had a residual intestinal length less than 1 m. Operative 30-day mortality and major morbidity rates were 10% and 51%, respectively. Median overall survival was 5.6 months (range, 0.1–49 months). One-year and 2-year overall survival rates were 18.3% (95% confidence interval, 5.1%–31.5%) and 8.1% (95% confidence interval, 0%–18.0)%, respectively. Within a median follow-up period of 5 months (range, 0.2–49 months), 4 patients (10.8%) are still alive. No significant differences in survival were seen between patients with or without major complications, tumor residuals, or residual intestinal length of less than 1 m versus greater than 1 m.Conclusions Salvage palliative surgery in EOC due to bowel obstruction resulting in SBS and in need of long-life total parenteral nutrition is associated with high morbidity rates and low overall survival. These surgeries should ideally be performed only in a multidisciplinary setting with adequate infrastructure and possibility of home care support. Conservative management should be the route of action in the absence of acute abdomen or intestinal perforation.