MANAGEMENT OF BOWEL OBSTRUCTION IN PATIENTS WITH ADVANCED OVARIAN-CANCER

In a retrospective study, 58 patients with bowel obstruction due to ad vanced ovarian cancer were analysed. In a forward stepwise proportiona l hazard regression analysis, we looked for factors influencing bowel obstruction-free survival. Patients who presented with bowel obstructi on as the first sign of ovarian cancer and those with a longer interva l between last cancer treatment and bowel obstruction did better. Pati ents with ascites did worse. No other independent factors were found. Based on these data, we classified patients into a favourable prognosi s group (no previous treatment or interval since last treatment exceed ing 6 months; no ascites) and a poor prognosis group (interval since l ast treatment shorter than 6 months; ascites). Patients from the favou rable prognosis group had a median bowel obstruction-free survival of 8 months, compared to 1 month for the poor prognosis group (P < 0.001) . Surgery had a marginally significant positive effect on bowel obstru ction-free survival when compared to medical treatment in the favourab le prognosis group (P = 0.052). Surgery had no effect at all in the po or prognosis patients.