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

Background and Objectives: 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 regard...

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Autores principales: Fiori, Enrico, Crocetti, Daniele, Sapienza, Paolo, Cirocchi, Roberto, Sterpetti, Antonio V., Miccini, Michelangelo, Accordino, Marcello, Costi, Silvano, Lapolla, Pierfrancesco, Mingoli, Andrea, De Toma, Giorgio, Lamazza, Antonietta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146574/
https://www.ncbi.nlm.nih.gov/pubmed/33925171
http://dx.doi.org/10.3390/medicina57050428
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author Fiori, Enrico
Crocetti, Daniele
Sapienza, Paolo
Cirocchi, Roberto
Sterpetti, Antonio V.
Miccini, Michelangelo
Accordino, Marcello
Costi, Silvano
Lapolla, Pierfrancesco
Mingoli, Andrea
De Toma, Giorgio
Lamazza, Antonietta
author_facet Fiori, Enrico
Crocetti, Daniele
Sapienza, Paolo
Cirocchi, Roberto
Sterpetti, Antonio V.
Miccini, Michelangelo
Accordino, Marcello
Costi, Silvano
Lapolla, Pierfrancesco
Mingoli, Andrea
De Toma, Giorgio
Lamazza, Antonietta
author_sort Fiori, Enrico
collection PubMed
description Background and Objectives: 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: 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: At 1-month, index values showed a statistically significant deterioration of the QoL in patients of Group 2 when compared to those of Group 1 (p = 0.004; CI: 0.04 to 0.21). No differences among the groups were recorded at 3-month; whereas, at 6-month, the index values showed a statistically significant deterioration of the QoL in patients of Group 1 (p = 0.009; CI: −0.25 to −0.043). 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.
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spelling pubmed-81465742021-05-26 Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL Fiori, Enrico Crocetti, Daniele Sapienza, Paolo Cirocchi, Roberto Sterpetti, Antonio V. Miccini, Michelangelo Accordino, Marcello Costi, Silvano Lapolla, Pierfrancesco Mingoli, Andrea De Toma, Giorgio Lamazza, Antonietta Medicina (Kaunas) Article Background and Objectives: 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: 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: At 1-month, index values showed a statistically significant deterioration of the QoL in patients of Group 2 when compared to those of Group 1 (p = 0.004; CI: 0.04 to 0.21). No differences among the groups were recorded at 3-month; whereas, at 6-month, the index values showed a statistically significant deterioration of the QoL in patients of Group 1 (p = 0.009; CI: −0.25 to −0.043). 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. MDPI 2021-04-28 /pmc/articles/PMC8146574/ /pubmed/33925171 http://dx.doi.org/10.3390/medicina57050428 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fiori, Enrico
Crocetti, Daniele
Sapienza, Paolo
Cirocchi, Roberto
Sterpetti, Antonio V.
Miccini, Michelangelo
Accordino, Marcello
Costi, Silvano
Lapolla, Pierfrancesco
Mingoli, Andrea
De Toma, Giorgio
Lamazza, Antonietta
Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title_full Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title_fullStr Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title_full_unstemmed Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title_short Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL
title_sort palliative surgery or metallic stent positioning for advanced gastric cancer: differences in qol
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146574/
https://www.ncbi.nlm.nih.gov/pubmed/33925171
http://dx.doi.org/10.3390/medicina57050428
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