e20564 Background: The purpose of this study was to identify clinical and radiographic factors relevant to treatment outcomes in cancer patients presenting with bowel obstruction. Methods: Clinical and radiographic factors were retrospectively abstracted from records of inpatients referred for surgical consultation for suspected bowel obstruction (2000–2006). Patients were stratified by treatment: surgical treatment (ST), minimally invasive (percutaneous/endoscopic) procedures (MIP), or bowel rest (BR). Clinical outcomes such as status at discharge and median overall survival (OS) were examined. Results: Of 194 patients, 25% had a primary diagnosis of colorectal cancer. Computed tomography, plain radiographs, enteral contrast studies, and other modalities were used for diagnosis in 59%, 26%, 12%, and 3% of patients, respectively. 62% of obstructions were located in the small bowel, with the remaining 23% and 12% identified as gastric outlet and colon, respectively. Over 90% of patients treated with ST (n = 60) were discharged home and tolerated enteral feeding. In contrast, for patients treated with MIP and BR, 48% and 68% were discharged home, and 70% and 72% were able to tolerate enteral feeding, respectively. OS was similar for patients treated with ST (6.3 months) and for those whose bowel obstruction resolved with BR (6.4 months). For patients treated with MIP, however, OS was 1.4 months. Though significant differences in OS for patients treated with ST and MIP were observed (p<0.0001), 30-day readmission rates were similar across treatment groups. Radiographic images demonstrating low grade obstruction, absence of ascites, and the absence of peritoneal carcinomatosis were associated with improved OS. Additional relevant clinical factors affecting OS included serum albumin level; however, no association was observed for age, tumor type, site of obstruction, previous bowel obstruction, or abdominal exploration. Conclusions: Clinical and radiographic factors affect treatment outcomes for cancer patients with bowel obstruction. Given that factors such as ascites, peritoneal carcinomatosis and low serum albumin result in poor OS, non-invasive procedures should be considered. No significant financial relationships to disclose.