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Risk Stratified Multidisciplinary Ambulatory Management of Malignant Bowel Obstruction in Gynecological Cancers

Recruiting
Conditions
Gynecologic Cancer
Registration Number
NCT03260647
Lead Sponsor
University Health Network, Toronto
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.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
150
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 exclusion criteria for this study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Optimization of multidisciplinary care2 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 Outcome Measures
NameTimeMethod
Improve patient understanding and awareness of MBO2 years

To improve patients' understanding and awareness of MBO with patient education material.

Evaluation of impact of MBO management on patient reported outcomes2 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 MBO2 years

To evaluate the nutritional status of patients with MBO

• Measured by monthly albumin and weight

Evaluation of clinico-pathological factors2 years

To evaluate the clinico-pathological factors that may predict benefit from palliative surgery, chemotherapy and total parenteral nutrition (TPN)

Record changes in the sum and types of gut microbiome from baseline to study end1.5 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

Determine percentage number of patient microbiome sample analyses completed1.5 years

To record the percentage of patients who agree to, and for whom sample collection and analysis is completed

Evaluate cannabis use in patient population1.5 years

Assess for any relationship between cannabis use and MBO

Evaluation of treatment outcomes2 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

Evaluation of impact of MBO management on hospital visits2 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

Trial Locations

Locations (1)

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

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