Gynecologic Cancer
Conditions
Brief summary
Management of Malignant Bowel Obstruction (MBO) in Patients with Advanced Gynecological Cancers
Detailed description
Guidelines for the management of patients with Malignant Bowel Obstruction(MBO) are not available and as such, there remains an urgent need for a collaborative approach to streamline patient care and optimize use of hospital resources. This study will focus on management of MBO in advanced gynecological cancers.If patients with MBO can be effectively managed in an ambulatory setting, this may improve quality and consistency of patient care, and help reduce volume and duration of bed occupancy.
Interventions
OTHERManagement algorithm for Malignant Bowel Obstruction
a proposed management algorithm for MBO has been developed to provide a pathway that safeguards quality and continuity of care for patients under a multidisciplinary team. It will engage key-stakeholders and foster an inter-professional approach. It incorporates an in-patient management algorithm and a novel nursing-led ambulatory management algorithm to supplement patient's medical management
Sponsors
University Health Network, Toronto
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Histologically and /or cytologically confirmed gynecological cancer, including ovarian, fallopian tube, endometrial, cervical or primary peritoneal cancer Deemed to be at risk of developing or have a clinical diagnosis of MBO as defined using the following criteria: clinical evidence of bowel obstruction (history/physical/radiological examination; and bowel obstruction beyond the ligament of Treitz.
Exclusion criteria
There are no specified
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Optimization of multidisciplinary care | 2 years | To optimize the multidisciplinary care management of MBO in patients with advanced gynecological cancer treated at University Health Network (UHN) which include in-patient and ambulatory management algorithm for MBO • Measured by a ratio of days alive and out of hospital compare to days in hospital within the first 60 days after diagnosis of MBO |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of impact of MBO management on hospital visits | 2 years | To evaluate the impact of MBO management on number of emergency room visits, hospital admission and number of days alive and outside of hospital within the first 168 days (6 months) after the diagnosis of MBO |
| Evaluation of impact of MBO management on patient reported outcomes | 2 years | To evaluate the impact of ambulatory MBO management on patient reported outcomes using the Distress Assessment & Response Tool (DART) |
| To evaluate nutritional status of patients with MBO | 2 years | To evaluate the nutritional status of patients with MBO • Measured by monthly albumin and weight |
| Evaluation of clinico-pathological factors | 2 years | To evaluate the clinico-pathological factors that may predict benefit from palliative surgery, chemotherapy and total parenteral nutrition (TPN) |
| Evaluation of treatment outcomes | 2 years | To evaluate the treatment outcomes of patients with MBO * Measured by resolution of MBO and overall survival * Measured by transition through specific bowel management colour code system |
| Determine percentage number of patient microbiome sample analyses completed | 1.5 years | To record the percentage of patients who agree to, and for whom sample collection and analysis is completed |
| Record changes in the sum and types of gut microbiome from baseline to study end | 1.5 years | Changes in the sum as well as types of microbiomes as recorded at baseline, initiation of total parenteral nutrition, incidence of an MBO and end of study are to be recorded |
| Evaluate cannabis use in patient population | 1.5 years | Assess for any relationship between cannabis use and MBO |
| Improve patient understanding and awareness of MBO | 2 years | To improve patients' understanding and awareness of MBO with patient education material. |
Countries
Canada
Outcome results
None listed