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)

Intestinal anastomoses using Valtrac-Bar biofragmentable rings were performed in 9 advanced ovarian cancer patients presenting with symptoms of acute or subacute intestinal obstruction. Two ileo-transversal anastomoses, six sigmo-rectal and one ileo-ileal ones were performed. A part of sigmoid colon with tumour causing obstruction was resected in seven patients and in two patients a resection of an ileal loop was performed. In two patients a colostomy was necessary. The result of anastomosis with Valtrac-Bar was satisfactory in all patients: no cases of peritonitis, anastomosis leak or fistulae were observed. The treatment of intestinal obstruction allowed for a prolongation and improvement of quality of life of these patients and enabled further treatment with chemotherapy. We conclude that biofragmentable Valtrac-Bar ring is a safe and effective device enabling easy and fast intestinal anastomosis even in patients with inappropriate healing.
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PMID:[The use of biodegradable valtrac-bar rings for intestinal anastomosis in advanced ovarian cancer patients]. 959 87

Intestinal obstruction in the patient with ovarian cancer is a difficult situation for both patient and physician. In women presenting with ovarian cancer, obstruction is almost never complete. These women should undergo aggressive bowel surgery only if it is part of an optimal surgical cytoreduction. Women known to have ovarian cancer who develop intestinal obstruction have a poor prognosis: Few will live more than a year from the time of obstruction. Some, however, have an excellent performance status, and would be relatively unimpaired were it not for their obstruction. These women, who usually have a discrete obstruction and still display some response to chemotherapy, may benefit from surgical correction of the obstruction. Women who are not candidates for surgery can be effectively palliated pharmacologically so that they are comfortable with the obstruction, often without intestinal drainage. Algorithms are available to assist in the management of ovarian cancer patients with obstruction, but ultimately the treatment decision rests with the patient. The oncologist must use his or her knowledge and clinical judgment to help the patient develop an appropriate, individualized plan.
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PMID:Management of intestinal obstruction in the patient with ovarian cancer. 1098 27

In recurrent ovarian cancer secondary surgery may be an important opportunity to improve survival and quality of life. In order to give a general overview of the available evidence, we discuss published data on the role of secondary surgery in relapsing ovarian cancer. The median survival after secondary surgery has been reported ranging from 16 to 29 months, and seems to be longer in subjects with optimal debulked disease. However, as with front-line debulking, it is difficult to establish whether the secondary debulking itself has a therapeutic, or even a lasting palliative effect, or whether the patients in whom the procedure is successful are those who have more indolent disease. Any benefit of treatment must be compared with potential morbidity. Post-operative complications are reported in about 25--30% of cases, with a potential impact on hospital stay. During the natural course of the disease, most patients with ovarian cancer develop intestinal obstruction, without impairment of other vital organs or pain. Reported series have suggested that palliative surgery for bowel obstruction is generally feasible in most patients. Some prognostic factors have been suggested to identify patients likely to benefit most from palliative surgery: young age seemed to be associated with longer survival after successful surgery for bowel obstruction, though this finding was not statistically significant. The site of obstruction does not seem to be related to survival after surgery.
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PMID:Role of secondary surgery in relapsed ovarian cancer. 1116 85

The aim of this study was to determine whether the addition of whole body hyperthermia (WBH) to carboplatin (CBDCA) can induce responses in patients with platinum-resistant ovarian cancer. 16 pretreated patients with platinum-resistant ovarian cancer were entered on a Systemic Hyperthermia Oncological Working Group (SHOWG) study; (14 patients were eligible with 14 evaluable for toxicity and 12 for response). The patients were treated with WBH (Aquatherm) 41.8 degrees C x 60 min in combination with carboplatin (CBDCA) (area under the curve (AUC) of 8) every 4 weeks. Disease status was evaluated every two cycles. Patients were treated for a maximum of six cycles. One patient had a complete response (CR) and 4 had a partial response (PR). 4 patients had stable disease (SD). 3 patients had progressive disease (PD). 2 patients were unevaluable: 1 had a bowel obstruction shortly after her first treatment; the second patient achieved a CR, but only had one treatment secondary to an idiosyncratic reaction to sedative drugs. 2 patients entered on study were ineligible, as they did not meet criteria for platinum resistance; 1 entered a CR and 1 had SD. Dose-limiting toxicity, which required CBDCA dose reductions, was grade 4 thrombocytopenia. Other toxicities included neutropenia (grade 3/4), and nausea and/or vomiting. Consistent with preclinical modelling, these results suggests that 41.8 degrees C WBH can overcome platinum resistance in ovarian cancer. These observations suggest further investigation of the therapeutic potential of WBH in a group of patients who historically fail to respond to salvage therapies is warranted.
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PMID:A pilot study of whole body hyperthermia and carboplatin in platinum-resistant ovarian cancer. 1137 41

In ovarian cancer patients the poor nutritional status and cachexia are caused by the metabolic effects of the enlarging tumor masses and bowel obstruction. These patients may have a high resting energy expenditure due to increase in Cori cycle activity, glucose and triglyceride-fatty acid cycling and gluconeogenesis. Biochemical mediators of cachexia include cytokines, such as tumor necrosis factor and interleukin-6, and tumor-produced catabolic factors, such as lipid-mobilizing factor, proteolysis-inducing factor, and anemia-inducing factor. Mechanisms involved in the pathogenesis of obstruction may include extrinsic occlusion of the bowel due to pelvic, mesenteric omental masses, or intestinal motility disorders due to infilor tration of the mesentery or bowel muscle and nerves. The relief of malnutrition and cachexia may be attempted through nutritional support, pharmacological approach (megestrol acetate, cyclooxygenase inhibitors) and palliative treatment of bowel obstruction. Very few agents have been demonstrated to have true anticachectic activity, so future research should be addressed to the identification of drugs able to block the activity of tumor-produced catabolic factors. The decision regarding optimum management of bowel obstruction should be individualized. Krebs' and Goplerud's score (based on age, nutritional status, tumor status, ascites, previous chemotherapy and irradiation) seems to offer reliable eligibility criteria for those patients who can benefit from surgery.
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PMID:Malnutrition and cachexia in ovarian cancer patients: pathophysiology and management. 1171 91

Bowel obstruction may be a mode of presentation of intra-abdominal and pelvic malignancy or a feature of recurrent disease following anticancer therapy. Malignant bowel obstruction is well-recognized in gynecologic patients with advanced cancer. Retrospective and autopsy studies found the frequency at approximately 5-51% of patients with gynecological malignancy(1-7). Malignant bowel obstruction (MBO) is particularly frequent in patients with ovarian cancer where it is the most frequent cause of death(7). Patients with stage III and IV ovarian cancer and those with high-grade lesions are at higher risk for MBO as compared to patients with lower stage or low-grade tumors(1,8). Ovarian carcinoma accounted for 50% of small bowel obstruction and 37% of large bowel obstruction treated in a large gynecological oncology service(8-11).
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PMID:Palliative management of malignant bowel obstruction. 1197 72

Ovarian cancer remains the leading gynecologic cause of death in the United States and the Western world. Progression to metastatic disease prior to diagnosis contributes to the high mortality rate associated with ovarian cancer. The current article reviews surgical and drug therapies for ovarian cancer. Prognostic factors and preventative treatment are also discussed. Surgery is essential for accurate staging of ovarian cancer and treatment. Cytoreduction, combined with chemotherapy, may relieve symptoms associated with bowel obstruction and improve survival. Management of early-stage ovarian cancer depends upon risk status determined via comprehensive staging at the time of surgical resection. High-risk, but not low-risk, patients require adjuvant chemotherapy. Studies comparing various combinations of cytotoxic agents for the treatment of advanced stage ovarian cancer are described. Despite surgery and chemotherapy, ovarian cancer recurs in approximately 50% of patients. Management of recurrent ovarian cancer and maintenance therapy following remission are discussed.
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PMID:Update on the management of ovarian cancer. 1207 99

A 40-year-old woman was admitted in emergency condition with the symptomatology of bowel obstruction. Intraoperative findings consists of a pelvic fixed tumoral mass, and numerous other tumors spread in the whole abdominal cavity mimicking a peritoneal carcinomatosis without liver metastases. Three of the tumors where about 4 cm in diameter producing stenosis of the terminal ileurn and sigma. We considered the case as it was a peritoneal carcinomatosis caused by an uterus or ovarian cancer and we decided for palliative surgery, performing ileo-transversostomy and sigmoidostomy above the obstruction. The histopathologic findings from more pieces of tumors revealed endometriosis without cancerous changes. Postoperative the patient underwent cytostatic and then hormonal therapy. After 3 month the CT scan revealed an important reducing in volume of the pelvic tumoral mass and the barium enema didn't showed any stenosis under the colostomy so, we closed it extraperitonealy. At 16 month after the first operation the patient was reoperated for a parietal defect. At the second look we found no tumors. The pelvic tumoral mass has disappeared, the uterus seemed to be normal but two big ovary cysts were present. We performed bilateral adnexectomy and the repair of the parietal defect. Postoperative evolution was favorable without any complication or complains at 3 month after the last operation.
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PMID:[Intestinal obstruction caused by abdominal pseudotumoral endometriosis mimicking a peritoneal carcinomatosis--case report]. 1273 Dec 40

An estimated 2,500 women were diagnosed with and 1,500 died from ovarian cancer in Canada in 2002. Up to 42% of patients in the palliative phase develop a malignant bowel obstruction. Options for management include medical therapy, surgery, and/or a percutaneous endoscopic gastrostomy (PEG) tube. The objective of this quality improvement study was to: 1) examine if successful palliation was achieved using a PEG tube, and 2) identify opportunities to improve the quality of nursing care provided. A retrospective review of 24 patient records revealed that 75% did not have nausea/vomiting by time of discharge; 92% resumed a clear fluid diet; 83% were discharged from the acute care setting; and 70% did not require re-admission. A PEG tube may effectively palliate women with non-operable bowel obstruction in advanced/recurrent cancer of the ovary. Opportunities for improving care are presented.
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PMID:Managing bowel obstruction in ovarian cancer using a percutaneous endoscopic gastrostomy (PEG) tube. 1469 64

Malignant bowel obstruction is the cause of death in the majority of women who die of ovarian cancer. Some patients are considered acceptable surgical candidates for relief of the obstruction. For many patients, however, lack of such surgical options has spawned a broad range of medical interventions, including palliative strategies to target pain and nausea and vomiting. This review discusses the general approach to patients with ovarian cancer and inoperable malignant bowel obstruction, with an emphasis on such palliative strategies.
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PMID:Pathophysiology and palliation of inoperable bowel obstruction in patients with ovarian cancer. 1535 17


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