ArticleCureus2026
Medical Versus Surgical/Endoscopic Management of Malignant Bowel Obstruction in Patients With End-Stage Gynecologic Cancer: A 12-Year Single-Center Experience.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
introductionMalignant bowel obstruction (MBO) is among the most challenging aspects of late-stage gynecologic cancer care. Surgical/endoscopic interventions carry high complication risks in patients with carcinomatous peritonitis and cachexia. This study examines the impact of surgical/endoscopic interventions on survival time in patients with gynecologic cancer.
methodsWe conducted a 12-year retrospective chart review (2013-2024) of all patients with MBO associated with cervical, endometrial, or ovarian cancer who received their initial treatment at our institutions. This MBO cohort was divided into two treatment groups: (i) medical management alone (nasogastric tube, long intestinal tube, octreotide) and (ii) surgical/endoscopic management (percutaneous endoscopic gastrostomy, metallic stent, bypass surgery, stoma formation). The primary outcome measure was 90-day survival from MBO onset; secondary outcome measures included the proportion of patients who, after MBO treatment, recovered oral intake and were discharged home. We compared survival times using Kaplan-Meier analyses and log-rank tests, and analyzed categorical data using the chi-square and Fisher's exact tests. Variables affecting survival time were assessed using the Cox proportional hazards model.
resultsA total of 45 cases of MBO were identified among 1,085 gynecologic cancer patients (4.1%). Of these, 95.5% (43/45) underwent some form of medical management. Of these 43 patients, 16 underwent surgical/endoscopic management. The proportion of patients who regained oral intake and were discharged home after MBO treatment was significantly higher in the surgical/endoscopic group (p < 0.001 for both outcomes). In multivariate analysis, surgical/endoscopic treatment was associated with more prolonged survival (hazard ratio (HR) 0.280; 95%CI 0.104-0.754, p = 0.012), whereas ascites severity was associated with shorter survival (HR 2.252; 95%CI 1.015-4.998, p = 0.046).
conclusionAt the end-of-life care for patients with late-stage gynecologic cancer and MBO, we found that surgical/endoscopic intervention better enabled resumption of oral intake and discharge to home without affecting survival time.
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