Survival and clinical outcome after endoscopic duodenal stent placement for malignant gastric outlet obstruction: comparison of pancreatic cancer and nonpancreatic cancer.
Gastrointest Endosc
; 82(3): 460-8.e2, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-25851162
ABSTRACT
BACKGROUND:
Data on endoscopic stenting of malignant gastric outlet obstruction (GOO) are based on studies predominantly involving patients with pancreatic adenocarcinoma.OBJECTIVE:
To compare survival and clinical outcome after stent placement for GOO due to pancreatic cancer compared with nonpancreatic cancer.DESIGN:
Retrospective study.SETTING:
Single tertiary hospital. PATIENTS A total of 292 patients with malignant GOO. INTERVENTION Stent placement. MAIN OUTCOME MEASUREMENTS Post-stent placement survival and clinical outcome.RESULTS:
In 196 patients with pancreatic cancer and 96 with nonpancreatic cancer, median post-stent placement survival was similar (2.7 months in pancreatic cancer vs 2.4 months in nonpancreatic cancer). Overall survival was shorter in patients with pancreatic cancer (13.7 vs 17.1 months; P = .004). Clinical success rates at 2 months (71% vs 91%) and reintervention rates (30% vs 23%) were comparable. Post-stent placement chemotherapy and the absence of distant metastasis were associated with better post-stent placement survival in both groups (pancreatic cancer chemotherapy vs no chemotherapy, 5.4 vs 1.5 months, P < .0001; metastasis vs no metastasis, 1.8 vs 4.6, P = .005; nonpancreatic cancer chemotherapy vs no chemotherapy, 9.2 vs 1.8, P = .001; metastasis vs no metastasis, 2.1 vs 6.1, P = .009).LIMITATIONS:
Retrospective study.CONCLUSIONS:
In this large series of patients undergoing stent placement for malignant GOO in North America, we observed no difference in post-stent placement survival despite better overall survival in patients with nonpancreatic cancer. GOO is a marker for poor survival in malignancy, regardless of the type. Chemotherapy and the absence of distant metastasis were associated with better post-stent placement survival in both groups.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
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Neoplasias Gástricas
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Neoplasias dos Ductos Biliares
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Adenocarcinoma
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Stents
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Obstrução da Saída Gástrica
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Colangiocarcinoma
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Neoplasias Duodenais
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Duodeno
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article