Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL.


Journal

Medicina (Kaunas, Lithuania)
ISSN: 1648-9144
Titre abrégé: Medicina (Kaunas)
Pays: Switzerland
ID NLM: 9425208

Informations de publication

Date de publication:
28 Apr 2021
Historique:
received: 11 02 2021
revised: 12 04 2021
accepted: 27 04 2021
entrez: 30 4 2021
pubmed: 1 5 2021
medline: 15 5 2021
Statut: epublish

Résumé

Twenty percent of the patients affected with stage IV antropyloric stomach cancer are hospitalized with a gastric outlet obstruction syndrome (GOOS) requiring its resolution to improve the quality of life (QoL). We present our preliminary short- and mid-term results regarding the influence of endoscopic placement of self-expandable metal stent (SEMS) or open stomach-partitioning gastrojejunostomy in QoL. In this prospective randomized longitudinal cohort trial, we randomly assigned 27 patients affected with stage IV antropyloric stomach cancer into two groups: Group 1 (13 patients) who underwent SEMS positioning and Group 2 (14 patients) in whom open stomach-partitioning gastrojejunostomy was performed. The Karnofsky performance scale and QoL assessment using the EQ-5D-5L™ questionnaire was administered before treatment and thereafter at 1, 3, and 6 months. Results Early QoL of patients affected with stage IV antropyloric cancer and symptoms of GOOS is significantly better in patients treated with SEMS positioning but at 6-month the QoL significantly decrease in this group of patients. We explained the reasons of this fluctuation with the higher risk of re-hospital admission in the SEMS group.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
Twenty percent of the patients affected with stage IV antropyloric stomach cancer are hospitalized with a gastric outlet obstruction syndrome (GOOS) requiring its resolution to improve the quality of life (QoL). We present our preliminary short- and mid-term results regarding the influence of endoscopic placement of self-expandable metal stent (SEMS) or open stomach-partitioning gastrojejunostomy in QoL.
MATERIALS AND METHODS METHODS
In this prospective randomized longitudinal cohort trial, we randomly assigned 27 patients affected with stage IV antropyloric stomach cancer into two groups: Group 1 (13 patients) who underwent SEMS positioning and Group 2 (14 patients) in whom open stomach-partitioning gastrojejunostomy was performed. The Karnofsky performance scale and QoL assessment using the EQ-5D-5L™ questionnaire was administered before treatment and thereafter at 1, 3, and 6 months. Results
CONCLUSIONS CONCLUSIONS
Early QoL of patients affected with stage IV antropyloric cancer and symptoms of GOOS is significantly better in patients treated with SEMS positioning but at 6-month the QoL significantly decrease in this group of patients. We explained the reasons of this fluctuation with the higher risk of re-hospital admission in the SEMS group.

Identifiants

pubmed: 33925171
pii: medicina57050428
doi: 10.3390/medicina57050428
pmc: PMC8146574
pii:
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Enrico Fiori (E)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Daniele Crocetti (D)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Paolo Sapienza (P)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Roberto Cirocchi (R)

Department of Surgical and Biomedical Sciences, Perugia University, 06123 Terni, Italy.

Antonio V Sterpetti (AV)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Michelangelo Miccini (M)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Marcello Accordino (M)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Silvano Costi (S)

Department of Economics and Finance, LUISS Guido Carli, 00198 Rome, Italy.

Pierfrancesco Lapolla (P)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Andrea Mingoli (A)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Giorgio De Toma (G)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

Antonietta Lamazza (A)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, 00161 Rome, Italy.

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