scholarly journals Multicentre observational study of quality of life after surgical palliation of malignant gastric outlet obstruction for gastric cancer

BJS Open ◽  
2017 ◽  
Vol 1 (6) ◽  
pp. 165-174 ◽  
Author(s):  
K. Fujitani ◽  
M. Ando ◽  
K. Sakamaki ◽  
M. Terashima ◽  
R. Kawabata ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Observational Study ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Malignant Gastric Outlet Obstruction ◽  
Surgical Palliation

A prospective multicenter observational study of surgical palliation examining postoperative quality of life in patients treated for malignant gastric outlet obstruction caused by incurable advanced gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Kazumasa Fujitani ◽  
Masahiko Ando ◽  
Kentaro Sakamaki ◽  
Masanori Terashima ◽  
Ryohei Kawabata ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Oral Intake ◽  
Malignant Gastric Outlet Obstruction ◽  
Surgical Palliation ◽  
The Mean

6 Background: Decision-making for surgical palliation remains one of the most challenging clinical scenarios since quality of life (QOL) is a key component of cancer care. We conducted this study to examine the impacts of surgical palliation on postoperative QOL in patients (pts) with malignant gastric outlet obstruction (GOO) caused by incurable primary gastric cancer (GC). Methods: Eligibility included (1) no oral intake or liquids only requiring parenteral nutrition (2) aged ≥20 (3) surgically fit (4) ECOG PS of 0-2 and (5) written IC. Patients underwent either palliative distal/total gastrectomy (DG/TG) or gastrojejunostomy (GJS). Treatment choice was left to the discretion of the physician. Validated QOL instruments (EORTC QLQ-STO22 and EuroQol-5D) assessed QOL at baseline, 2 weeks (wks), 1 month (m), and 3 months following the surgical palliation, and two observational outcomes (postoperative improvement of oral intake, and safety of surgical intervention) were evaluated. Results: 104 pts, 71 males and 33 females with a median age of 68 years, were enrolled. The types of surgery were DG in 23 pts, TG in 9 pts, GJS in 70 in pts, and exploratory laparotomy in 2 pts. Baseline QOL questionnaires were completed by 103 (99.0%) pts. Among the 104 pts, 98 (94.2%), 100 (96.1%), and 81 (77.9%) completed the 2-wk, 1-m, and 3-m follow-up survey, respectively. The mean baseline EQ-5D score was 0.74 (SD, 0.21). During the follow-up period, the mean scores remained consistent with the baseline scores; the change from baseline score was within ± 0.05 for the index. Many pts came to eat solid food at 2 wks postsurgery and remained tolerable thereafter (from 0 at baseline to 82, 85, 75 pts at 2 wks, 1 m, and 3 ms, respectively). Overall morbidity rate of ≥grade 3 on Clavien-Dindo classification and 30-day postoperative mortality rate was 9.6% (10 pts) and 2.0% (2 pts) with a median hospital stay of 13 days and re-operation rate of 3.9% (4 pts). Conclusions: In pts with malignant GOO caused by advanced GC, surgical palliation maintained patient QOL while improving solid food intake with an acceptable surgical safety. Clinical trial information: UMIN000023494.

Palliation for Malignant Gastric Outlet Obstruction: A Prospective Quality of Life Study

2008 ◽  
Vol 67 (5) ◽  
pp. AB251
Author(s):  
Carl R. Schmidt ◽  
Hans Gerdes ◽  
William G. Hawkins ◽  
Erica Zucker ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Life Study ◽  
Malignant Gastric Outlet Obstruction

A survival analysis of a prospective multicenter observational study of surgical palliation in patients treated for malignant gastric outlet obstruction caused by incurable advanced gastric cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 113-113
Author(s):  
Masanori Terashima ◽  
Kazumasa Fujitani ◽  
Masahiko Ando ◽  
Kentaro Sakamaki ◽  
Ryohei Kawabata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Analysis ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Oral Intake ◽  
Good Survival ◽  
Malignant Gastric Outlet Obstruction ◽  
Surgical Palliation

113 Background: We previously reported that surgical palliation maintained patients’ quality of life (QOL) while improving the solid food intake with an acceptable surgical safety in patients with malignant gastric outlet obstruction (GOO) caused by advanced gastric cancer. To elucidate the impact of the improvement in the QOL on the survival, we performed a survival analysis according to the changes in the QOL. Methods: Eligibility criteria included (1) no or liquids-only oral intake, (2) aged ≥20 , (3) surgically fit, (4) ECOG PS of 0-2, and (5) written informed consent. Patients underwent either palliative gastrectomy or gastrojejunostomy. Validated QOL instruments (EORTC QLQ-STO22 and EuroQol-5D) assessed the QOL at baseline, 2 weeks, 1 month, and 3 months following surgical palliation, and postoperative improvement in the oral intake was also evaluated. Univariate and multivariate survival analyses were performed according to baseline characteristics and changes in QOL 2 weeks, 1 month, and 3 months after the operation. Results: The median survival time in the 104 patients was 11.30 months. In the univariate analysis, the survival was significantly better in the patients who received gastrectomy, received adjuvant chemotherapy, had a better PS, and had a worse baseline EQ5D score. Changes in the QOL scores had no marked impact on the survival at 2 weeks and 1 month after operation. However, in patients with an improved or stable EQ5D score at 3 months post-surgery, the survival was significantly better (p = 0.0043). An improved oral intake on the GOO score system (GOOSS) had a positive impact on the survival. A multivariate analysis in the patients survived more than 3 months after the operation revealed that adjuvant chemotherapy, a better baseline PS, a worse baseline EQ5D, an improved or stable EQ5D score, and an improved oral intake on the GOOSS at 3 months after surgical palliation were independent prognostic factors. Conclusions: In patients who received surgical palliation for malignant GOO caused by advanced gastric cancer, an improved oral intake and QOL score at 3 months after operation predicted a good survival. Clinical trial information: 000023494.

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