Predictive factors for malignant large bowel obstruction in colorectal cancer patients

This study investigated the predictive factors of malignant large bowel obstruction (MLBO) in incurable stage 4 colorectal cancer. Researchers suggested that MLBO is associated with tumor ulceration (when a tumor breaks through the skin’s surface), location and width.

An MLBO is a blockage of the intestine which stops the normal movements of the bowel caused by the presence of a tumor. These colorectal cancer patients have a poorer prognosis. A prior study suggested that 11% of patients with stage 4 colorectal cancer develop a complication such as MLBO. In these patients, MLBO in often difficult to detect due to the slow progress of the blockage and hard to define symptoms. Therefore, the detection of predictive factors for MBLO is necessary to better make decisions regarding the treatment options and timing.  

The objective of this study was to identify predictive factors for MLBO in stage 4 colorectal cancer patients undergoing chemotherapy.

This study included information about 216 stage 4 colorectal cancer patients receiving chemotherapy. Patients were divided in two groups: MLBO group (46 patients) and non-MLBO group (170 patients). The average time between diagnosis and MLBO was 9.8 months.

The development of MLBO in these patients was associated with the space occupied by the tumor, the tumor location and width and tumor ulceration. Patients with tumors occupying a larger space were 3% more at risk of MLBO. Patients with wider tumor width were 3.5% more at risk of MLBO. Patients with tumor location at a turning point in the colon were 2.4 times more at risk of having MLBO. Patients with tumor ulceration were 3.76 times more at risk of having MLBO.

This study showed that factors such as tumor location, width and ulceration are associated with MLBO in stage 4 colorectal cancer patients receiving chemotherapy.