Outcomes of small bowel obstruction in patients with previous gynecologic malignancies

BackgroundFeatures predictive of malignant small bowel obstructions among patients with previous gynecologic malignancies remain undetermined.MethodsPredictors of malignancy and mortality among patients with gynecologic malignancies and bowel obstructions were identified through a retrospective review of records.ResultsMalignancy was noted among 69.8% of 189 patients included in the analysis. Advanced-stage cancer (P = .006, odds ratio [OR] = 6.62), ovarian malignancy (P = .001, OR = 25.64), and early-onset obstruction (P = .014) predicted malignant etiology, whereas chemotherapy (P < .001, OR = .02) or radiation therapy (P = .027, OR = .09) predicted benign obstruction. The average survival was 9 months versus 49 months for malignant and benign obstructions, respectively. Ovarian cancer (P = .009, hazard ratio [HR] = 4.45), anemia (P = .001, HR = 1.11), and renal dysfunction (P < .001, HR 1.81) impaired survival.ConclusionsPalliative care should be considered for patients with advanced-stage cancer, ovarian malignancy, and a shorter time interval between cancer diagnosis and bowel obstruction, especially in the setting of anemia and renal dysfunction.