ArticleAnnals of surgery2018
Survival, Healthcare Utilization, and End-of-life Care Among Older Adults With Malignancy-associated Bowel Obstruction: Comparative Study of Surgery, Venting Gastrostomy, or Medical Management.
Article in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Inoperable malignant bowel obstruction: palliative interventions outcomes - mixed-methods systematic review.BMJ supportive & palliative care · 2024Pooled it
- The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review.Palliative medicine · 2022Pooled it
- Percutaneous transesophageal gastric catheter removal and follow up: A case series.Radiology case reports · 2026Article
- Review
- A Multi-State Cohort Study of Hospital Utilization and Treatment Modality for Malignant Gastrointestinal Obstructions.Journal of surgical oncology · 2026Article
- Non-surgical management of malignant bowel obstruction: strategies and outcomes in inoperable patients.Journal of gastrointestinal oncology · 2026Article
- The feasibility and safety of deeply inserted enema tubes for acute malignant left-hemicolon obstruction: an alternative solution in developing countries.Frontiers in oncology · 2025Article
- The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis.Annals of surgical oncology · 2024Article
- A predictive model for colorectal cancer complicated with intestinal obstruction based on specific inflammation score.BMC cancer · 2024Article
- Surgical Palliation for Malignant Bowel Obstruction in Preventing Hospital Readmission: Experience of a Tertiary Care Center.Annals of surgical oncology · 2024Article
- Metastatic Uterine Leiomyosarcoma presenting as small bowel intussusception at two independent visits.Gynecologic oncology reports · 2024Article
- Article
- Multidisciplinary approach, continuous care and opioid management in cancer pain: case series and review of the literature.Drugs in context · 2023Article
- Developing and Field Testing BOLSTER: A Nurse-Led Care Management Intervention to Support Patients and Caregivers following Hospitalization for Gynecologic Cancer-Associated Peritoneal Carcinomatosis.Journal of palliative medicine · 2022Article
- Racial Disparities in Surgery for Malignant Bowel Obstruction.Annals of surgical oncology · 2022Article
- Gaps in patient-physician communication at the time of malignant bowel obstruction from recurrent gynecologic cancer: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Illness Understanding, Prognostic Awareness, and End-of-Life Care in Patients With GI Cancer and Malignant Bowel Obstruction With Drainage Percutaneous Endoscopic Gastrostomy.JCO oncology practice · 2021Article
- Conceptualizing and Counting Discretionary Utilization in the Final 100 Days of Life: A Scoping Review.Journal of pain and symptom management · 2020Article
- The Value of Haematological Parameters and Tumour Markers in the Prediction of Intestinal Obstruction in 1474 Chinese Colorectal Cancer Patients.Disease markers · 2020Article
- The role of parenteral nutrition in patients with malignant bowel obstruction.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveTo compare survival, readmissions, and end-of-life care after palliative procedures compared with medical management for malignancy-associated bowel obstruction (MBO).
backgroundMBO is a late complication of intra-abdominal malignancy for which surgeons are frequently consulted. Decisions about palliative treatments, which include medical management, surgery, or venting gastrostomy tube (VGT), are hampered by the paucity of outcomes data relevant to patients approaching the end of life.
methodsRetrospective study using 2001 to 2012 Surveillance, Epidemiology, and End Results-Medicare data of patients 65 years or older with stage IV ovarian or pancreatic cancer who were hospitalized for MBO. Multivariate competing-risks regression models were used to compare the following outcomes: survival, readmission for MBO, hospice enrollment, intensive care unit (ICU) care in the last days of life, and location of death in an acute care hospital.
resultsMedian survival after MBO admission was 76 days (interquartile range 26-319 days). Survival was shorter after VGT [38 days (interquartile range 23-69)] than medical management [72 days (23-312)] or surgery [128 days (42-483)]. As compared to medical management, patients treated with VGT had fewer readmissions [subdistribution hazard ratio 0.41 (0.29-0.58)], increased hospice enrollment [1.65 (1.42-1.91)], and less ICU care [0.69 (0.52-0.93)] and in-hospital death [0.47 (0.36-0.63)]. Surgery was associated with fewer readmissions [0.69 (0.59-0.80)], decreased hospice enrollment [0.84 (0.76-0.92)], and higher likelihood of ICU care [1.38 (1.17-1.64)].
conclusionsVGT is associated with fewer readmissions and lower intensity healthcare utilization at the end of life than do medical management or surgery. Given the limited survival, regardless of management, hospitalization with MBO carries prognostic significance and presents a critical opportunity to identify patients' priorities for end-of-life care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.