Fernandes et al identified prognostic factors for a woman with bowel obstruction cause by ovarian cancer. These can help to identify a patient who may benefit from more aggressive management. The authors are from McGill University and Montreal General Hospital.
Patient selection: woman with bowel obstruction secondary to ovarian cancer
Parameters evaluated by univariate analysis:
(1) age in years at the time of ovarian cancer diagnosis
(2) ascites
(3) serum albumin concentration
(4) blood urea nitrogen (BUN) concentration
(5) serum alkaline phosphatase concentration
(6) history of previous radiotherapy
(7) tumor stage
(8) abdominal X-ray findings
(9) interval between diagnosis of ovarian cancer and onset of obstruction
|
Parameter |
Finding |
Points |
|
age in years |
<= 60 years of age |
0 |
|
|
> 60 yearsof age |
1 |
|
ascites |
absent |
0 |
|
|
present |
1 |
|
serum albumin |
normal |
0 |
|
|
low |
1 |
|
serum BUN |
normal |
0 |
|
|
elevated |
1 |
|
serum alkaline phosphatase |
normal |
0 |
|
|
elevated |
1 |
|
history of radiotherapy |
present |
0 |
|
|
absent |
1 |
|
tumor stage |
Stage I or II |
0 |
|
|
Stage III or IV |
1 |
|
abdominal X-ray |
bowel obstruction |
0 |
|
|
normal or ileus |
1 |
|
interval from tumor diagnosis |
long |
0 |
|
|
short (<= 100 weeks) |
1 |
number of factors associated with a worse prognosis =
= SUM(points for all 9 parameters)
Interpretation:
• minimum number of factors: 0
• maximum number of factors: 9
• The more factors that are present the worse the prognosis.
Limitations:
• The study performed a univariate analysis. A promised multivariate analysis could not be found.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,
