MASCC Multidisciplinary Evidence-Based Recommendations for the Management of Malignant Bowel Obstruction in Advanced Cancer

Abstract

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 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.