BACKGROUND: Due to low life expectancy, treatment strategies for malignant bowel obstruction (MBO) due to peritoneal carcinomatosis (PC) emphasize improved quality of life and symptom relief. Currently, the value of palliative surgery to treat obstructive PC is unclear. METHODS: A prospectively registered search strategy (PROSPERO) was utilized to identify articles examining outcomes of patients undergoing surgical palliation for MBO from PC in PubMed (2003-2013). Primary outcomes of interest were median overall survival (OS) and treatment complications. RESULTS: Of 730 articles screened, 64 were selected for full-text review and 5 were quantitatively synthesized. This comprised 313 patients with MBO, of which 249 (79.5%) presented with PC. The mean age was 61.4 years (range 51-67). The OS for surgical patients was 6.4 months (2.8-19.7, n = 190). Stratification by surgical technique suggested an OS of resection, ostomy, and enteral bypass as 7.2 months (n = 174), 3.4 months (n = 9), and 2.7 months (n = 7), respectively. Major complications occurred in 37.0% of patients that underwent resection. CONCLUSIONS: This study supports surgical resection over surgical bypass to treat obstructive PC, as it offered better OS with fewer complications. Higher quality studies are needed to conclusively assess the role of surgery in patients with obstructive PC.
BACKGROUND: Due to low life expectancy, treatment strategies for malignant bowel obstruction (MBO) due to peritoneal carcinomatosis (PC) emphasize improved quality of life and symptom relief. Currently, the value of palliative surgery to treat obstructive PC is unclear. METHODS: A prospectively registered search strategy (PROSPERO) was utilized to identify articles examining outcomes of patients undergoing surgical palliation for MBO from PC in PubMed (2003-2013). Primary outcomes of interest were median overall survival (OS) and treatment complications. RESULTS: Of 730 articles screened, 64 were selected for full-text review and 5 were quantitatively synthesized. This comprised 313 patients with MBO, of which 249 (79.5%) presented with PC. The mean age was 61.4 years (range 51-67). The OS for surgical patients was 6.4 months (2.8-19.7, n = 190). Stratification by surgical technique suggested an OS of resection, ostomy, and enteral bypass as 7.2 months (n = 174), 3.4 months (n = 9), and 2.7 months (n = 7), respectively. Major complications occurred in 37.0% of patients that underwent resection. CONCLUSIONS: This study supports surgical resection over surgical bypass to treat obstructive PC, as it offered better OS with fewer complications. Higher quality studies are needed to conclusively assess the role of surgery in patients with obstructive PC.
Authors: Pinuccia Faviana; Laura Boldrini; Barbara Musco; Mauro Ferrari; Alfonso Greco; Lorenzo Fornaro; Gianluca Masi; Francesco Forfori; Sergio Ricci; Augusto Brogi; Fulvio Basolo; Alfredo Falcone; Angelo Gadducci; Piero Vincenzo Lippolis Journal: In Vivo Date: 2020 Jul-Aug Impact factor: 2.155
Authors: Phillip J Hsu; Khushboo Singh; Ankit Dhiman; Hunter D D Witmer; Chuan He; Oliver S Eng; Daniel V T Catenacci; Mitchell C Posner; Kiran K Turaga Journal: JCO Precis Oncol Date: 2022-02
Authors: Gary B Deutsch; Jeremiah L Deneve; Mazin F Al-Kasspooles; Valentine N Nfonsam; Camille C Gunderson; Angeles Alvarez Secord; Phillip Rodgers; Samantha Hendren; Eric J Silberfein; Marcia Grant; Jeff Sloan; Virginia Sun; Kathryn B Arnold; Garnet L Anderson; Robert S Krouse Journal: Am J Hosp Palliat Care Date: 2019-05-23 Impact factor: 2.500
Authors: Andrew S Miller; Kathryn Boyce; Benjamin Box; Matthew D Clarke; Sarah E Duff; Niamh M Foley; Richard J Guy; Lisa H Massey; George Ramsay; Dominic A J Slade; James A Stephenson; Phil J Tozer; Danette Wright Journal: Colorectal Dis Date: 2021-02 Impact factor: 3.917