Abstract / Description
IntroductionAdvanced ovarian cancer complicated by malignant bowel obstruction is generally considered a terminal event, especially when deemed inoperable, with an expected survival of only a few weeks. We report the case of a patient who was initially judged inoperable but who survived approximately 40 months without disease progression thanks to an active multidisciplinary approach.Case presentationA 76-year-old woman presented with bowel obstruction, massive ascites, and an Eastern Cooperative Oncology Group performance status of 4. Ultrasound-guided peritoneal biopsy confirmed a high-grade serous carcinoma of gynecological origin. After a multidisciplinary team discussion, the patient was deemed unsuited to surgical management. Despite this, she received total parenteral nutritional support and symptomatic control, followed by three cycles of neoadjuvant carboplatin-paclitaxel. This treatment led to a substantial reduction in her disease burden and an improvement in her performance status, permitting interval debulking surgery. The outcome of surgery was optimal cytoreduction (residual disease