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CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature

SIMPLE SUMMARY: Malignant bowel obstruction (MBO) requires adequate palliation in progressive ovarian cancer. Percutaneous endoscopic gastrostomy has limitations in 32.7% of patients with advanced/recurrent ovarian cancer due to anatomical constraints and a lack of transillumination. CT-guided gastr...

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Autores principales: Canaz, Emel, Sehouli, Jalid, Gebauer, Bernhard, Segger, Laura, Collettini, Federico, Auer, Timo Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526206/
https://www.ncbi.nlm.nih.gov/pubmed/37760510
http://dx.doi.org/10.3390/cancers15184540
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author Canaz, Emel
Sehouli, Jalid
Gebauer, Bernhard
Segger, Laura
Collettini, Federico
Auer, Timo Alexander
author_facet Canaz, Emel
Sehouli, Jalid
Gebauer, Bernhard
Segger, Laura
Collettini, Federico
Auer, Timo Alexander
author_sort Canaz, Emel
collection PubMed
description SIMPLE SUMMARY: Malignant bowel obstruction (MBO) requires adequate palliation in progressive ovarian cancer. Percutaneous endoscopic gastrostomy has limitations in 32.7% of patients with advanced/recurrent ovarian cancer due to anatomical constraints and a lack of transillumination. CT-guided gastrostomy is a safe and effective procedure, enabling rapid recognition of the anatomy, particularly in complex patients with peritoneal carcinomatosis and previous multivisceral surgeries. This technique should be particularly emphasized within the palliative management of MBO. A clinical registry should be implemented to evaluate the effectiveness of various treatment strategies in MBOs associated with gynaecological cancers. ABSTRACT: Peritoneal carcinomatosis-associated malignant bowel obstruction is a common feature that merits more attention in advanced and recurrent ovarian cancer. Decompressive gastrostomy is one of the most preferred methods to palliate distressing symptoms and maintain patients’ quality of life. We retrospectively identified 31 patients with ovarian cancer-associated MBO, who underwent decompressive CT fluoroscopy-guided percutaneous gastrostomy (CT-PG) between September 2015 and April 2023 at our institution. A systematic literature review was conducted for CT-guided gastrostomy in ovarian cancer. Prior to CT-PG, 27 (87%) patients underwent unsuccessful attempts at endoscopic gastrostomy or surgery due to bowel obstruction; a total of 55% had received ≥3 lines of chemotherapy. CT-PG could be successfully inserted in 25 of 31 (81%) patients without grade 4–5 complications. CT-PG insertion was feasible in 76% of patients with previous unsuccessful attempts of endoscopic gastrostomy. A total of 80% of patients with a successful insertion had considerable symptom relief and could tolerate fluid intake. Mean survival after the procedure was 44.4 days. Chemotherapy could be administered in 7 of 25 (28%) patients following the CT-PG insertion. CT-guided percutaneous gastrostomy is a safe procedure that effectively manages intractable symptoms of bowel obstruction in ovarian cancer. This minimally invasive technique should be emphasised as a routine instrument within the palliative management of MBO.
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spelling pubmed-105262062023-09-28 CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature Canaz, Emel Sehouli, Jalid Gebauer, Bernhard Segger, Laura Collettini, Federico Auer, Timo Alexander Cancers (Basel) Article SIMPLE SUMMARY: Malignant bowel obstruction (MBO) requires adequate palliation in progressive ovarian cancer. Percutaneous endoscopic gastrostomy has limitations in 32.7% of patients with advanced/recurrent ovarian cancer due to anatomical constraints and a lack of transillumination. CT-guided gastrostomy is a safe and effective procedure, enabling rapid recognition of the anatomy, particularly in complex patients with peritoneal carcinomatosis and previous multivisceral surgeries. This technique should be particularly emphasized within the palliative management of MBO. A clinical registry should be implemented to evaluate the effectiveness of various treatment strategies in MBOs associated with gynaecological cancers. ABSTRACT: Peritoneal carcinomatosis-associated malignant bowel obstruction is a common feature that merits more attention in advanced and recurrent ovarian cancer. Decompressive gastrostomy is one of the most preferred methods to palliate distressing symptoms and maintain patients’ quality of life. We retrospectively identified 31 patients with ovarian cancer-associated MBO, who underwent decompressive CT fluoroscopy-guided percutaneous gastrostomy (CT-PG) between September 2015 and April 2023 at our institution. A systematic literature review was conducted for CT-guided gastrostomy in ovarian cancer. Prior to CT-PG, 27 (87%) patients underwent unsuccessful attempts at endoscopic gastrostomy or surgery due to bowel obstruction; a total of 55% had received ≥3 lines of chemotherapy. CT-PG could be successfully inserted in 25 of 31 (81%) patients without grade 4–5 complications. CT-PG insertion was feasible in 76% of patients with previous unsuccessful attempts of endoscopic gastrostomy. A total of 80% of patients with a successful insertion had considerable symptom relief and could tolerate fluid intake. Mean survival after the procedure was 44.4 days. Chemotherapy could be administered in 7 of 25 (28%) patients following the CT-PG insertion. CT-guided percutaneous gastrostomy is a safe procedure that effectively manages intractable symptoms of bowel obstruction in ovarian cancer. This minimally invasive technique should be emphasised as a routine instrument within the palliative management of MBO. MDPI 2023-09-13 /pmc/articles/PMC10526206/ /pubmed/37760510 http://dx.doi.org/10.3390/cancers15184540 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Canaz, Emel
Sehouli, Jalid
Gebauer, Bernhard
Segger, Laura
Collettini, Federico
Auer, Timo Alexander
CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title_full CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title_fullStr CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title_full_unstemmed CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title_short CT Fluoroscopy-Guided Percutaneous Gastrostomy in the Palliative Management of Advanced and Relapsed Ovarian Cancer: The Charité Experiences and a Review of the Literature
title_sort ct fluoroscopy-guided percutaneous gastrostomy in the palliative management of advanced and relapsed ovarian cancer: the charité experiences and a review of the literature
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526206/
https://www.ncbi.nlm.nih.gov/pubmed/37760510
http://dx.doi.org/10.3390/cancers15184540
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