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

Autor: Canaz E; Charité Comprehensive Cancer Center (CCCC), European Competence Center for Ovarian Cancer (EKZE), Department of Gynaecology and Gynaecological Oncology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany., Sehouli J; Charité Comprehensive Cancer Center (CCCC), European Competence Center for Ovarian Cancer (EKZE), Department of Gynaecology and Gynaecological Oncology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany., Gebauer B; Department of Radiology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany., Segger L; Department of Radiology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany., Collettini F; Department of Radiology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany.; Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany., Auer TA; Department of Radiology, Charité-University Medicine of Berlin, Campus Charité Virchow, 13353 Berlin, Germany.; Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Sep 13; Vol. 15 (18). Date of Electronic Publication: 2023 Sep 13.
DOI: 10.3390/cancers15184540
Abstrakt: 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.
Databáze: MEDLINE
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