BENEFIT OF PALLIATIVE SURGERY FOR BOWEL OBSTRUCTION IN ADVANCED OVARIAN-CANCER

OBJECTIVES: To determine the benefit of palliative surgery for patient s with advanced ovarian cancer and bowel obstruction and to identify c riteria for selecting patients who are most likely to benefit from pal liation. DESIGN: A retrospective study of patients treated between 198 2 and 1992. SETTING: A university-affiliated hospital. PATIENTS: Fifty -three patients with complete and unresolved bowel obstruction caused by ovarian cancer. INTERVENTION: Surgery for relief of bowel obstructi on. MAIN OUTCOME MEASURES: Postoperative survival longer than 60 days, return home and relief of bowel obstruction for longer than 60 days, factors associated with failure of palliative surgery. RESULTS: Succes sful palliation was achieved in 27 (51%) patients and was associated w ith the absence of four prognostic factors: palpable abdominal and pel vic masses, ascites exceeding 3 L, multiple obstructive sites and preo perative weight loss greater than 9 kg. Age, time interval between dia gnosis of ovarian cancer and bowel obstruction, stage of disease at in itial diagnosis, tumour type and grade, site and degree of obstruction , presence of gross residual tumour after initial operation and preope rative use of chemotherapy or radiotherapy did not indicate the succes s or failure of palliative surgery. CONCLUSIONS: Palliative surgery fo r bowel obstruction in advanced ovarian cancer can be worthwhile, and there are four prognostic factors that indicate the likely failure of palliation.