Abstract CN105
Background
Malignant bowel obstruction (MBO) is a frequent complication in patients with advanced cancer. There are no national guidelines for the management of patients presenting with MBO. Clinical management relies on an individualised approach, based on prognosis and objectives of care. The priority of care for non-operable disease is symptom control and supportive management to either resume or start systemic anticancer therapy (SACT) if appropriate.
Methods
Data were collected via retrospective analysis of electronic patient records for patients referred to Chelsea and Westminster Hospitals AOS service from Jan 2023 to Dec 2023 with SBO. Eligible patients had newly diagnosed or known advanced solid cancers. The primary objective was to assess how many patients received systemic anticancer treatment after supportive management. Secondary objectives were to evaluate the timeliness of nutrition team input and if total parenteral nutrition (TPN) was started.
Results
There were 24 referrals to AOS with either bowel obstruction or gastric outlet obstruction. The median age was 60y (26-80) and 62.5% were females. 91.6% of patients had an existing diagnosis of cancer and all had metastatic disease. Most patients (87.5%) were managed conservatively, 40% received steroids and 12.5% received surgery or stenting. Only 36% received further SACT and only 50% of patient had a specialist palliative care team referral during their acute admission. More than 70% of all patients were referred to dieticians with median of 3 days (1-9) and 25% of patient received TPN. 28% of all patients did not receive SACT following this admission and 24% of all patients died during admission.
Conclusions
This study highlights the current variation in practice for patients presenting with MBO requiring supportive care. Decision making in this clinical scenario can be challenging and need to be tailored to individual patients who have a poor prognosis. All patients should have MDT discussion around nutrition, symptom control and care goals. No national guidelines exist and development of local and national guidance is warranted to improve symptoms and optimise patient care.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
CN40 - Nutritional risk screening (NRS 2002), Prognostic nutritional index (PNI) and Controlling nutritional status (CONUT) in patients with digestive cancer: An observational study
Presenter: Keti Ballfusha
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN41 - The RES-project, an on-going intervention aimed at increasing breast cancer screening attendance, among socioeconomically challenged groups
Presenter: Nina Markholm Nordgren
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN42 - Is breast cancer in men ignored? An awareness study
Presenter: Derya ÇInar
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN43 - Comprehensive pan-cancer exploration of the ubiquitin-proteasome system: A bidirectional Bayesian Weighted Mendelian randomization study
Presenter: Fei Zhu
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN44 - Genetic associations between pan-cancer and phenotype of COVID-19: A bidirectional Bayesian Weighted Mendelian randomization study
Presenter: Yaxin Kang
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN45 - Climate change, climate disasters and oncology care: A global survey of oncology nurses
Presenter: İsmail Toyğar
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN46 - Evaluation of efficacy of controlled cooling of the extremities for prevention of chemotherapy-induced peripheral neuropathy and conservation of dose intensity: A Dutch, nurse led observational pilot study
Presenter: Chantal Roth
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN55 - Improving physical activity in breast cancer: A nurse-led logical framework project
Presenter: EIRINI THROUVALA
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN56 - A nurse-led physical activity educational intervention to improve quality of life in breast cancer women undergoing chemotherapy: A study protocol
Presenter: Maria Lavdaniti
Session: EONS Poster Display session
Resources:
Abstract
Slides
CN57 - Proposals for implementation of a multidimensional platform for the advancement of oncology nursing in Latin America (The INCREASE proposal)
Presenter: Jairo Zuluaga
Session: EONS Poster Display session
Resources:
Abstract
Slides