MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer

Ainhoa Madariaga; Jenny Lau; Arunangshu Ghoshal; Tomasz Dzierżanowski; Philip Larkin; Jacek Sobocki; Andrew Dickman; Kate Furness; Rouhi Fazelzad; Gregory B Crawford; Stephanie Lheureux

doi:10.1007/s00520-022-06889-8

MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer

Support Care Cancer. 2022 Jun;30(6):4711-4728. doi: 10.1007/s00520-022-06889-8. Epub 2022 Mar 10.

Authors

Ainhoa Madariaga^{1

2

3}, Jenny Lau⁴, Arunangshu Ghoshal⁴, Tomasz Dzierżanowski⁵, Philip Larkin⁶, Jacek Sobocki⁷, Andrew Dickman⁸, Kate Furness⁹, Rouhi Fazelzad¹⁰, Gregory B Crawford^{11

12}, Stephanie Lheureux¹³

Affiliations

¹ Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada.
² Autonomous University of Barcelona, Barcelona, Spain.
³ 12 Octubre University Hospital, Madrid, Spain.
⁴ Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada.
⁵ Laboratory of Palliative Medicine, Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland.
⁶ Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁷ Department of General Surgery and Clinical Nutrition, Centre for Postgraduate Medical Education, Warsaw, Poland.
⁸ Academic Palliative and End of Life Care Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, UK.
⁹ Department of Dietetics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.
¹⁰ Library and information services, University of Health Network, Toronto, Canada.
¹¹ Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia.
¹² Discipline of Medicine, University of Adelaide, Adelaide, Australia.
¹³ Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada. stephanie.lheureux@uhn.ca.

Abstract

Purpose: To provide evidence-based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer.

Methods: The Multinational Association for Supportive Care in Cancer (MASCC) MBO study group conducted a systematic review of databases (inception to March 2021) to identify studies about patients with advanced cancer and MBO that reported on the following outcomes: symptom management, bowel obstruction resolution, prognosis, overall survival, and quality of life. The review was restricted to studies published in English, but no restrictions were placed on publication year, country, and study type. As per the MASCC Guidelines Policy, the findings were synthesized to determine the levels of evidence to support each MBO intervention and, ultimately, the graded recommendations and suggestions.

Results: The systematic review identified 17,656 published studies and 397 selected for the guidelines. The MASCC study group developed a total of 25 evidence-based suggestions and recommendations about the management of MBO-related nausea and vomiting, bowel movements, pain, inflammation, bowel decompression, and nutrition. Expert consensus-based guidance about advanced care planning and psychosocial support is also provided.

Conclusion: This MASCC Guideline provides comprehensive, evidence-based recommendations about MBO management for patients with advanced cancer.

Keywords: Cancer—gastrointestinal; Guidelines; Gynecologic neoplasm; Malignant bowel obstruction; Palliative Care.

Publication types

Systematic Review

MeSH terms

Humans
Intestinal Obstruction* / surgery
Intestinal Obstruction* / therapy
Nausea
Neoplasms* / complications
Neoplasms* / therapy
Palliative Care
Quality of Life