Chen PJ, Wang L, Peng YF, Chen N, Wu AW. Surgical intervention for malignant bowel obstruction caused by gastrointestinal malignancies. World J Gastrointest Oncol 2020; 12(3): 323-331 [PMID: 32206182 DOI: 10.4251/wjgo.v12.i3.323]
Corresponding Author of This Article
Ai-Wen Wu, MD, PhD, Full Professor, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. wuaw@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2020; 12(3): 323-331 Published online Mar 15, 2020. doi: 10.4251/wjgo.v12.i3.323
Surgical intervention for malignant bowel obstruction caused by gastrointestinal malignancies
Peng-Ju Chen, Lin Wang, Yi-Fan Peng, Nan Chen, Ai-Wen Wu
Peng-Ju Chen, Lin Wang, Yi-Fan Peng, Nan Chen, Ai-Wen Wu, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Chen PJ, Wang L and Peng YF contributed equally to this work; Chen PJ and Wang L designed research; Peng YF performed research; Chen N analyzed data; Chen PJ, Peng YF and Wu AW wrote the paper.
Supported byNational Natural Science Foundation of China, No. 81773214.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Peking University Cancer Hospital and Institute, approval No. 2019YJZ46.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data.
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ai-Wen Wu, MD, PhD, Full Professor, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. wuaw@sina.com
Received: September 27, 2019 Peer-review started: September 27, 2019 First decision: November 18, 2019 Revised: November 27, 2019 Accepted: January 14, 2020 Article in press: January 14, 2020 Published online: March 15, 2020 Processing time: 167 Days and 4.1 Hours
ARTICLE HIGHLIGHTS
Research background
Malignant bowel obstruction (MBO) is a frequent event for end-stage malignant cancers. There is no consensus on the optimal treatment strategy for improving quality of life and prolonging survival. There were fewer studies focused on the surgical intervention of MBO with gastrointestinal (GI) cancers.
Research motivation
We wanted to investigate the effects of palliative surgery for MBO in patients with GI cancers in order to guide treatment.
Research objectives
To define the surgical outcome difference between massive debulking surgery (MDS) and ostomy/by-pass surgery (OBS) for MBO patients with GI cancer.
Research methods
MBO patients with GI cancer receive palliative surgery were included MDS group and OBS group. This study mainly investigated the difference of short outcome and survival between the two groups.
Research results
This study reported that patients in the MDS group had significantly higher symptom palliation rate than OBS group, and the median survival time in the MDS group was significantly longer than in the OBS group.
Research conclusions
Massive debulking surgery can significantly improve symptom and prolong survival for MBO patients with colorectal cancer, without increasing mortality and morbidity rates compared with ostomy/by-pass surgery. However, MDS had no such advantage in gastric cancer.
Research perspectives
The treatment of MBO remained controversial and no well-evidenced. This small sample study demonstrates the effectiveness, safety and survival benefit of massive debulking surgery in colorectal cancer patients with MBO. It is difficult to carry out large sample randomized controlled study. In the future, it is necessary to establish a large sample registration study.
