Resumption of oncological therapy in patients with advanced cancer undergoing explorative laparotomy for bowel obstruction

Ilze Ose, Ismail Gögenur, Mai-Britt Tolstrup

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Abstrakt

INTRODUCTION: Obstruction of the gastrointestinal tract is a frequent surgical emergency experienced by patients with advanced cancers. We aimed to evaluate factors associated with resumption of post-operative chemotherapy in patients with advanced cancer undergoing explorative laparotomy for bowel obstruction.

METHODS: This retrospective cohort study was conducted between 2009 and 2013 at Herlev Hospital, Denmark. All patients with advanced cancer were identified from a local electronic database containing all emergency laparotomies. Adult patients with mechanical bowel obstruction were included if they had any kind of cancer and had been under active oncological treatment within the last eight weeks prior to surgery. Demographic, clinical, pre-, and post-operative data were collected and reviewed manually. Multivariate logistic regression analysis was performed to identify predictors for resuming oncological treatment.

RESULTS: A total of 76 patients admitted with bowel obstruction and undergoing oncological treatment within eight weeks before surgery were included. Post-operatively, cancer treatment was resumed in 58% of patients. An American Society of Anesthesiologists (ASA) score less-than III (odds ratio = 12.6 (95% confidence interval (CI): 2.9-54.6); p = 0.001) and a performance status less-than 3 (odds ratio = 9.7 (95% CI: 1.4-67.2); p = 0.021) were associated with resuming post-operative cancer treatment.

CONCLUSIONS: We found that ASA score and performance status are associated with resumption of cancer treatment post-operatively and should be taken into consideration when considering the treatment strategy for patients with advanced cancer and malignant bowel obstruction.

FUNDING: The authors received no financial support for the research, authorship, and/or publication of this article.

TRIAL REGISTRATION: not relevant.

OriginalsprogEngelsk
ArtikelnummerA08190473
TidsskriftDanish medical journal
Vol/bind67
Udgave nummer7
StatusUdgivet - 1 jul. 2020

Bibliografisk note

Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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