Contemporary Outcomes Among Gynecologic Oncology Patients With Malignant Small Bowel Obstructions

Area of Science:

• Gynecologic Oncology
• Gastroenterology
• Palliative Care

Background:

• Malignant bowel obstructions (MBOs) are frequent complications of advanced gynecologic cancers.
• These obstructions significantly increase patient morbidity and mortality.
• Optimal management strategies for MBOs remain poorly defined.

Purpose of the Study:

• To describe contemporary outcomes for gynecologic oncology patients experiencing MBOs.
• To inform the development of prospective management strategies for MBOs.
• To analyze management interventions and patient outcomes in MBO cases.

Main Methods:

• Retrospective chart review of gynecologic oncology admissions for MBOs.
• Data collected from January 2019 to December 2023 at a single academic institution.
• Analysis included cancer type, treatment phase, interventions, goals of care, readmissions, hospice, and mortality.

Main Results:

• Ovarian cancer was most common (82%), often associated with recurrence.
• Bowel decompression via nasogastric tubes (50%) or gastrostomy tubes (18%) was frequent.
• High rates of 30-day readmission (39%), hospice utilization (28%), and mortality (13%) were observed.

Conclusions:

• Malignant bowel obstructions in gynecologic cancer patients are associated with poor prognosis.
• Variable management strategies were employed, with limited documentation of goals of care conversations.
• There is a critical need for evidence-based strategies to optimize care and improve outcomes for these patients.