Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1140680 (ovarian cancer)
 28,141 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fourteen patients with colonic obstruction as the initial manifestation of a malignant ovarian tumor are described. Although common in advanced ovarian tumor, bowel obstruction as the presenting feature of carcinoma of the ovary is not well recognized. Clinical features were that of partial or complete large bowel obstruction, roentgenographically and pathologically involving the sigmoid colon in 12 of 14 patients. Barium enema was abnormal in all 12 patients in whom it was performed. Prognosis may be more favorable in large bowel obstruction as the first clinical manifestation of ovarian cancer than in obstruction occurring in previously diagnosed disease. Our experience suggests that consideration of ovarian pathology is indicated in the presence of signs of large bowel obstruction in women.
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PMID:Colonic obstruction as the first manifestation of ovarian carcinoma. 379 77

The records and radiographs of 284 patients with gynecologic malignancy were reviewed to determine the incidence and nature of small-bowel abnormalities. Seventeen percent of the patients had small-bowel studies. Twenty-four percent of patients with ovarian cancer had radiologic examination of the small bowel, and in almost all cases the abnormalities were due to metastatic disease. In patients with cervical cancer, small-bowel radiography was performed in 14% of patients, and in most cases the abnormalities were due to radiation damage. Small-bowel obstruction was found in 20 patients. In the ovarian-cancer group, all obstructions were due to metastatic disease, whereas in the cervical cancer group, obstruction was due to metastases, radiation, or adhesions. The site of obstruction was a useful differential point, since all obstructions due to radiation were in the ileum, whereas 58% of obstructions due to metastases were in the duodenum or jejunum. The radiologic studies interpreted in light of the clinical circumstances were highly accurate in determining the location and nature of small-bowel complications in these patients.
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PMID:Radiography of the small bowel in patients with gynecologic malignancies. 387 Dec 74

Treatment of patients with advanced ovarian cancer who have failure of first-line chemotherapy is rarely effective. Preliminary pharmacokinetic and phase II clinical studies established the feasibility of delivering relatively high concentrations of cisplatin intraperitoneally via a semipermanent catheter, while using intravenous sodium thiosulfate as a neutralizing agent to decrease the nephrotoxicity of cisplatin. Sixty patients with advanced ovarian cancer, all of whom had failure of first-line chemotherapy (including cisplatin in 56 of 60), were treated with high-dose intraperitoneal cisplatin in combination with doxorubicin and/or cytarabine. Of the 46 patients evaluable for response, 19 (42%) showed an objective response, most often (12/19) disappearance of malignant ascites. No serious drug-associated morbidity was observed aside from three cases of intestinal obstruction which may have been due in part to drug-induced adhesions. It is felt that prospective studies to compare the efficacy of intraperitoneal chemotherapy with other forms of "salvage" therapy, as well as its use as initial chemotherapy for advanced ovarian cancer, need to be done.
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PMID:Intraperitoneal chemotherapy for advanced ovarian cancer. 392 84

The surgical management of 118 instances of bowel obstruction associated with advanced ovarian cancer in 98 patients is reviewed. In 12% of the treatment episodes, patients were found to have inoperable disease at laparotomy. Surgical correction of the intestinal obstruction was associated with an operative mortality of 12%. In 35% of the cases, patients did not benefit from surgical treatment, as they died within 8 weeks of the operation. Patients' age, nutritional status, tumor spread, presence of ascites, and the type and amount of prior chemotherapy and/or radiation therapy correlate well with the patients' prognosis. A simple prognostic index based upon these 6 criteria is suggested as a means of predicting the possible benefit from surgical intervention.
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PMID:Surgical management of bowel obstruction in advanced ovarian carcinoma. 682 74

Thirteen patients with rapidly advancing recurrent epithelial ovarian cancers, in whom chemotherapy and, in some cases, radiation therapy failed, were treated with the estrogen antagonist tamoxifen. The presence of cytosol estrogen receptors, which have recently been identified in ovarian cancer specimens, was determined in the tumor from each patient prior to tamoxifen treatment. No complete responses were observed. One patient had a partial response and 4 patients had prolonged stabilization of disease. All patients with stabilized disease had estrogen receptor levels that were borderline or high. Eight patients demonstrated no response to oral tamoxifen therapy, but 5 of these had partial small bowel obstruction secondary to advanced recurrent cancer. As tamoxifen in this preliminary study may have stabilized rapidly advancing recurrent ovarian cancer in combination with cytotoxic chemotherapy should be considered.
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PMID:Tamoxifen therapy for advanced ovarian cancer. 707 Jul 29

Bowel obstruction is a common and distressing outcome in patients with abdominal or pelvic cancer. Patients may develop bowel obstruction at any time in their clinical history, with a prevalence ranging from 5.5% to 42% in those with ovarian cancer and from 10% to 28.4% in those with colorectal cancer. The causes of the obstruction may be benign postoperative adhesions, a focal malignant or benign deposit, or relapse or diffuse carcinomatosis. The symptoms, which are almost always present, are intestinal colic, continuous abdominal pain, nausea, and vomiting. Although surgery should be the primary treatment for malignant obstruction, it is now recognized that some patients with advanced disease or in generally poor condition are unfit for surgery and require alternative management to relieve distressing symptoms. A number of treatment options are now available for the patient with advanced cancer who develops intestinal obstruction. In this review, the indications for surgery are examined, the use of nasogastric tube and percutaneous gastrostomy evaluated, and the pharmacologic approach described.
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PMID:Management of bowel obstruction in advanced cancer. 752 46

The records of 532 patients with advanced ovarian cancer during March 1977 to February 1993 were retrospectively reviewed. Fifty-seven cases developed intestinal obstruction, and 54 cases died of this complication. The median survival period for all patients with obstruction was 110 days, and only 5 cases survived for more than one year. Twenty-three cases were treated mainly by surgery, 18 by chemotherapy, and 16 by conservative measures. The median survival periods for each group was 96 days, 120 days, and 81 days, respectively. Their survival times are not statistically different (P > 0.05). Of the patients surgically treated, 61% (14/23) benefited from operation, 26% (6/23) had inoperable disease at laparotomy, and 9% (2/23) developed fatal surgical complications. Even though the response rate in patients receiving chemotherapy was much higher than in those surgically treated (P < 0.05), the effect of chemotherapy was just temporary, and occurred only in patients who had never been treated with high dose PDD-based regimens. In this report, the individualized management of intestinal obstruction induced by ovarian cancers is suggested, and indications and contraindications for three treatment modalities are proposed.
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PMID:[Management of intestinal obstruction in advanced ovarian cancer an analysis of 57 cases]. 765 86

Recurrent ovarian cancer after negative findings at second-look laparotomy is common. A retrospective review of 57 patients who developed recurrent tumor after a negative second-look laparotomy was undertaken to evaluate treatment efficacy and prognostic factors. All patients received primary platinum-based chemotherapy. Recurrences occurred in the abdomen or pelvis (40 patients), lymph nodes (7), liver (4), lungs (3), and vagina (3). Recurrent disease was diagnosed at a mean interval of 20 months after second-look surgery. Of the 38 patients who underwent laparotomy for recurrence, 36 (95%) had > 0.5 cm disease. After cytoreductive surgery 14 patients (37%) were left with minimal (< 0.5 cm) residual disease. Intestinal resection or bypass was performed on 10/38 patients (26%) with one requiring a colostomy. There was no operative mortality and one complication (small bowel obstruction). Treatment after recurrence consisted of platinum-based chemotherapy (88%), with the remaining patients receiving irradiation or hormonal therapy. At a mean follow-up from recurrence for the entire group of 20 months, 18/38 (47%) explored patients are alive. All 19 patients who were not explored died with a median survival time from recurrence of 9 months. Patients who underwent a laparotomy and patients with < 0.5 cm residual disease had a significant survival advantage (P < 0.0001). Initial stage, grade, disease-free interval, and disease found at laparotomy did not influence survival. Recurrent ovarian carcinoma after platinum-based chemotherapy is associated with a grave prognosis when the patient is deemed inoperable or when distant metastasis are found. Patients with disease reduced to < 0.5 cm showed a significant survival advantage.
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PMID:Cytoreductive surgery in ovarian carcinoma patients with a documented previously complete surgical response. 770 1

115 patients suffering from ovarian carcinoma were admitted from May 1976 through August 1991, and were treated with intra-peritoneal chemotherapy. A total of 191 catheters which with 2mm in diameter and 50 cm in length were inserted with 608 courses of chemotherapy. 29 plastic catheters used by 29 patients were kept for 18.4 days averagely, while 162 silica catheters used by 86 patients were kept 109 days in average. The duration of keeping silica catheters was significantly longer than plastic catheters (P < 0.01). Complications were found in 29 patients, 25.2% of the total: 5 cases of infection (4.3%), 2 of partial intestinal obstruction (1.7%), 4 of painful sensation (3.5%), 12 with inflow obstruction (10.4%) and 6 with falling off of the catheters (5.2%). Complications between the two groups were compared. There was no statistical significance (P < 0.05). When catheter retainment times of the two groups were compared, significant differences were found between plastic and silica catheters (P < 0.001). Our results indicate that both kinds of catheters may be used in intraperitoneal chemotherapy of ovarian cancer patients, and the silica ones seem better.
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PMID:[Analysis of complications associated with catheter intraperitoneal chemotherapy of ovarian carcinoma]. 771 2

A link between fertility drugs and epithelial ovarian cancer has been suggested by at least one case-control study, and by multiple case reports of such tumors developing following fertility drug therapy. We report the case of a woman with stage IC grade 1 mucinous epithelial ovarian cancer who died of recurrent disease shortly after receiving gonadotropin therapy for ovulation induction. The patient was initially treated with a staging procedure, unilateral salpingo-oophorectomy, and 3 courses of cytoxan and carboplatinum. Over the next 3 years she underwent 2 cycles of ovulation induction with exogenous gonadotropins. Five months after the second cycle, the patient presented with a bowel obstruction and extensive recurrence of disease. Two months later she died despite extensive surgical debulking, and cis-platinum and Taxol chemotherapy. Although a causal relationship between fertility therapy and ovarian cancer has not been established, this case report suggests ovulation induction may be inadvisable in a woman with a prior diagnosis of invasive epithelial ovarian cancer.
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PMID:Fertility therapy in the setting of a history of invasive epithelial ovarian cancer. 778 77


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