Incidence of intestinal obstruction following intraperitoneal chemotherapy for ovarian tubal and peritoneal malignancies Journal Article


Authors: Kehoe, S. M.; Williams, N. L.; Yakubu, R.; Levine, D. A.; Chi, D. S.; Sabbatini, P. J.; Aghajanian, C. A.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title: Incidence of intestinal obstruction following intraperitoneal chemotherapy for ovarian tubal and peritoneal malignancies
Abstract: Objectives: To report the incidence of intestinal obstruction after intraperitoneal chemotherapy (IP) in women with ovarian, tubal, or peritoneal malignancies, and determine the frequency of malignant versus adhesion-related obstruction. Methods: Patients who were treated with at least one dose of IP chemotherapy between 1986 and 1997, and who had at least 3 month follow-up, were included. Data regarding admissions for gastrointestinal obstruction complaints, radiologic diagnosis of intestinal obstruction and medical or surgical management of obstruction were recorded. Results: We identified 334 patients; 307 met our inclusion criteria. A total of 104 (34%) patients developed symptomatic intestinal obstruction after IP therapy commenced. The overall incidence of adhesion-related or mechanical bowel obstruction was only 4%. In the group of patients with a mechanical bowel obstruction, the median time to diagnosis of obstruction was 21 months (range, 2-51) after initiation of IP treatment. Surgical intervention to relieve the obstruction was performed in 6 (50%) patients diagnosed with adhesion-related bowel obstruction. Similarly, in those diagnosed with a malignant bowel obstruction, 42 (48%) were taken to the operating room in an attempt to relieve the obstruction. Conclusion: Intestinal obstructions developed in a third of patients who received IP therapy as part of their treatment for advanced ovarian, tubal, or peritoneal cancer. However, the majority of the obstructions are related to progression of malignant intra-abdominal disease. Only 4% of the patients develop intestinal obstruction due to intestinal adhesions after IP treatment. © 2009 Elsevier Inc. All rights reserved.
Keywords: adult; aged; middle aged; retrospective studies; major clinical study; percutaneous endoscopic gastrostomy; cisplatin; fluorouracil; gemcitabine; paclitaxel; cytarabine; follow up; antineoplastic agent; ovarian neoplasms; carboplatin; multiple cycle treatment; ovary cancer; peritoneum cancer; peritoneal neoplasms; etoposide; antineoplastic combined chemotherapy protocols; incidence; medical record review; retrospective study; conservative treatment; mitoxantrone; uterine tube carcinoma; intestine obstruction; intestinal obstruction; fallopian tube neoplasms; floxuridine; infusions, parenteral; intraperitoneal chemotherapy; ovarian tubal malignancies; peritoneal malignancies; gastrostomy; intestine surgery; catheters, indwelling
Journal Title: Gynecologic Oncology
Volume: 113
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2009-05-01
Start Page: 228
End Page: 232
Language: English
DOI: 10.1016/j.ygyno.2009.01.016
PUBMED: 19254808
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Richard R Barakat
    629 Barakat
  2. Dennis S Chi
    707 Chi
  3. Douglas A Levine
    380 Levine
  4. Paul J Sabbatini
    262 Sabbatini
  5. Siobhan Marie Kehoe
    22 Kehoe
  6. Rasheed Aimhanesi Yakubu
    2 Yakubu