Intestinal occlusion by gynecological cancers treated by percutaneous endoscopic gastrostomy and lanreotide: an Aviano N
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COMMENTARY
Intestinal occlusion by gynecological cancers treated by percutaneous endoscopic gastrostomy and lanreotide: an Aviano National Cancer Institute experience Martina Budel 1 & Luca Martella 2 & Laura Zambon 1 & Isabella Morson 1 & Giorgio Giorda 2 & Renato Cannizzaro 1,3 Received: 22 July 2020 / Accepted: 4 September 2020 # The Author(s) 2020
Abstract The Commentary reports on our experience in Centro di Riferimento Oncologico IRCCS Aviano about the integrated and combined treatment with percutaneous endoscopic gastrostomy and lanreotide in patients with bowel obstructions by ovarian cancer and peritoneal carcinomatosis. We treated patients with gynecological cancers and bowel obstruction with percutaneous endoscopic gastrostomy and, when patients were partially responsive, with lanreotide. We registered a constant overall benefit for the quality of life and for the control of symptoms, which is very important especially during the home care follow-up of terminal patients. Keywords Gynecological cancers . Percutaneous endoscopic gastrostomy . Lanreotide
Ovarian cancer is the eighth most common type of cancer in the world and it has the lowest survival rate of all gynecological cancers. In 2020, there is an estimation of about 21.750 new cases diagnosed per year and about 13,940 ovarian cancer deaths in the USA [1]. In many cases at the time of diagnosis, it is already at an advanced stage. Malignant bowel obstruction is a common and distressing complication of advanced gynecological cancer and peritoneal carcinomatosis. The obstruction gives rise to a vicious cycle of increased intestinal secretion and fluid accumulation with the resultant damage to the intestinal epithelium causing an inflammatory response [2]. The symptoms are principally nausea, vomiting, and abdominal pain: all these symptoms are debilitating for the patient and difficult to manage at home [3]. Management
of obstruction due to advanced cancer is likely to require intravenous hydration and parenteral nutrition alongside pharmaceutical interventions and the use of nasogastric tubes; however, these procedures are distressing for the patients. For this reason, the treatment of the terminal patients to improve and ensure a good quality of life is the primary goal of palliative care [4]. Almost all the patients with gynecological cancer have undergone multiple surgical treatments as well as a number of cycles of chemo- or radiotherapy [5]. The patients normally have a poor performance status, thus making surgical treatment a poor option due to the high mortality and morbidity rate [6, 7]. To date, gastrointestinal decompression through a nasogastric tube is the first-line procedure in patients with
Martina Budel and Luca Martella share first authorship. * Renato Cannizzaro [email protected] Martina Budel [email protected]
Giorgio Giorda [email protected] 1
Luca Martella [email protected]
Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
2
Laura Zambon [email protected]
Gynecolo
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