Abstract

Malignant bowel obstruction (MBO) is common in women with gynecologic cancer and is considered as a major clinical challenge due to the significant burden on patients, caregivers, and health systems [1]. Of all the gynecologic malignancies, ovarian cancer is the predominant cause of MBO and the deadliest malignancy. MBO is an important cause of morbidity and mortality of ovarian cancer, and its early detection may improve patient outcomes [2]. Although MBO may be the first manifestation in 20% of patients with gynecologic or gastrointestinal malignancies, in most cases, it is a sign of incurable recurrent disease [1, 3]. Among gynecologic cancers, MBO is more common in women with cancers of the ovaries, fallopian tubes, and peritoneum, and eventually affects up to 20% of patients. MBO has also been described as an end of life condition in 3 to 11% of patients with uterine cancer [4]. In retrospective studies, up to 51% of women with recurrent ovarian cancer developed MBO and their median survival after diagnosis of MBO ranged from 45 to 159 days. This rate was 124 to 408 days in patients who underwent palliative surgical intervention [1]. However, most cases of MBO in ovarian cancer are diagnosed when the bowel is involved at several levels and therefore are not a good candidate for surgical treatment [2].