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

Authors :
Enrico Fiori
Daniele Crocetti
Paolo Sapienza
Roberto Cirocchi
Antonio V. Sterpetti
Michelangelo Miccini
Marcello Accordino
Silvano Costi
Pierfrancesco Lapolla
Andrea Mingoli
Giorgio De Toma
Antonietta Lamazza
Source :
Medicina, Vol 57, Iss 5, p 428 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

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-5Lā„¢ 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: āˆ’0.25 to āˆ’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.

Details

Language :
English
ISSN :
16489144 and 1010660X
Volume :
57
Issue :
5
Database :
Directory of Open Access Journals
Journal :
Medicina
Publication Type :
Academic Journal
Accession number :
edsdoj.1a651988fc964cabbd46a969bcf1dbe2
Document Type :
article
Full Text :
https://doi.org/10.3390/medicina57050428