A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction
Abstract Background Gastric outlet obstruction (GOO) often complicates advanced malignancy. Palliative options include surgical bypass, endoscopic stent, percutaneous gastrostomy (PEG), or percutaneous jejunostomy (PEJ). Methods We enrolled 50 patients with GOO secondary to unresectable primary or m...
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| Veröffentlicht in: | The American journal of surgery 2009-07, Vol.198 (1), p.92-99 |
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| creator | Schmidt, Carl, M.D Gerdes, Hans, M.D Hawkins, William, M.D Zucker, Erica, B.A Zhou, Qin, M.A Riedel, Elyn, M.S Jaques, David, M.D Markowitz, Arnold, M.D Coit, Daniel, M.D Schattner, Mark, M.D |
| description | Abstract Background Gastric outlet obstruction (GOO) often complicates advanced malignancy. Palliative options include surgical bypass, endoscopic stent, percutaneous gastrostomy (PEG), or percutaneous jejunostomy (PEJ). Methods We enrolled 50 patients with GOO secondary to unresectable primary or metastatic cancer in a study examining palliative interventions. Validated instruments assessed quality of life (QOL) at baseline, 1 month, and 3 months following intervention. Results Median overall survival was 64 days. A shorter hospital stay and trend to lower mortality were observed after stent placement; solid food intake and rates of secondary intervention were comparable. Both stent and surgical bypass were associated with acceptable QOL outcomes. Fifteen patients refused participation at 1 month and 28 died of disease before 3 months, so 10 patients completed all surveys. Conclusions Although malignant GOO is associated with poor survival, there are reasonable alternatives for palliation. QOL studies are difficult to complete in this population due to severity of illness and short life expectancy. |
| doi_str_mv | 10.1016/j.amjsurg.2008.09.030 |
| format | Article |
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Palliative options include surgical bypass, endoscopic stent, percutaneous gastrostomy (PEG), or percutaneous jejunostomy (PEJ). Methods We enrolled 50 patients with GOO secondary to unresectable primary or metastatic cancer in a study examining palliative interventions. Validated instruments assessed quality of life (QOL) at baseline, 1 month, and 3 months following intervention. Results Median overall survival was 64 days. A shorter hospital stay and trend to lower mortality were observed after stent placement; solid food intake and rates of secondary intervention were comparable. Both stent and surgical bypass were associated with acceptable QOL outcomes. Fifteen patients refused participation at 1 month and 28 died of disease before 3 months, so 10 patients completed all surveys. Conclusions Although malignant GOO is associated with poor survival, there are reasonable alternatives for palliation. QOL studies are difficult to complete in this population due to severity of illness and short life expectancy.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2008.09.030</identifier><identifier>PMID: 19482259</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Abdominal neoplasm ; Biological and medical sciences ; Cancer ; Decision making ; Disease Progression ; Dysphagia ; Endoscopy ; Endoscopy, Gastrointestinal ; Fatalities ; Female ; Follow-Up Studies ; Food intake ; Gastric cancer ; Gastric outlet obstruction ; Gastric Outlet Obstruction - etiology ; Gastric Outlet Obstruction - psychology ; Gastric Outlet Obstruction - surgery ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Neoplasms - complications ; Gastrointestinal Neoplasms - epidemiology ; Gastrointestinal Neoplasms - psychology ; General aspects ; Humans ; Implants ; Intervention ; Laparoscopy ; Life expectancy ; Life span ; Malignancy ; Medical prognosis ; Medical sciences ; Metastases ; Metastasis ; New York - epidemiology ; Observational studies ; Ostomy ; Pain ; Palliation ; Palliative care ; Palliative Care - methods ; Patients ; Polyethylene glycol ; Prognosis ; Prospective Studies ; Quality assessment ; Quality of Life ; Questionnaires ; Stent ; Stents ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Studies ; Surgery ; Surgical implants ; Survival ; Survival Rate ; Time Factors ; Tumors</subject><ispartof>The American journal of surgery, 2009-07, Vol.198 (1), p.92-99</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jul 1, 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-5f1c906e6f66818c724542f20ddc463378cfa5352a849dcc5de7069329fb353e3</citedby><cites>FETCH-LOGICAL-c476t-5f1c906e6f66818c724542f20ddc463378cfa5352a849dcc5de7069329fb353e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961008008878$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21708179$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19482259$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmidt, Carl, M.D</creatorcontrib><creatorcontrib>Gerdes, Hans, M.D</creatorcontrib><creatorcontrib>Hawkins, William, M.D</creatorcontrib><creatorcontrib>Zucker, Erica, B.A</creatorcontrib><creatorcontrib>Zhou, Qin, M.A</creatorcontrib><creatorcontrib>Riedel, Elyn, M.S</creatorcontrib><creatorcontrib>Jaques, David, M.D</creatorcontrib><creatorcontrib>Markowitz, Arnold, M.D</creatorcontrib><creatorcontrib>Coit, Daniel, M.D</creatorcontrib><creatorcontrib>Schattner, Mark, M.D</creatorcontrib><title>A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Gastric outlet obstruction (GOO) often complicates advanced malignancy. Palliative options include surgical bypass, endoscopic stent, percutaneous gastrostomy (PEG), or percutaneous jejunostomy (PEJ). Methods We enrolled 50 patients with GOO secondary to unresectable primary or metastatic cancer in a study examining palliative interventions. Validated instruments assessed quality of life (QOL) at baseline, 1 month, and 3 months following intervention. Results Median overall survival was 64 days. A shorter hospital stay and trend to lower mortality were observed after stent placement; solid food intake and rates of secondary intervention were comparable. Both stent and surgical bypass were associated with acceptable QOL outcomes. Fifteen patients refused participation at 1 month and 28 died of disease before 3 months, so 10 patients completed all surveys. Conclusions Although malignant GOO is associated with poor survival, there are reasonable alternatives for palliation. QOL studies are difficult to complete in this population due to severity of illness and short life expectancy.</description><subject>Abdomen</subject><subject>Abdominal neoplasm</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Decision making</subject><subject>Disease Progression</subject><subject>Dysphagia</subject><subject>Endoscopy</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Fatalities</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Food intake</subject><subject>Gastric cancer</subject><subject>Gastric outlet obstruction</subject><subject>Gastric Outlet Obstruction - etiology</subject><subject>Gastric Outlet Obstruction - psychology</subject><subject>Gastric Outlet Obstruction - surgery</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Neoplasms - complications</subject><subject>Gastrointestinal Neoplasms - epidemiology</subject><subject>Gastrointestinal Neoplasms - psychology</subject><subject>General aspects</subject><subject>Humans</subject><subject>Implants</subject><subject>Intervention</subject><subject>Laparoscopy</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Malignancy</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>New York - epidemiology</subject><subject>Observational studies</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Palliation</subject><subject>Palliative care</subject><subject>Palliative Care - methods</subject><subject>Patients</subject><subject>Polyethylene glycol</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Quality assessment</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Stent</subject><subject>Stents</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Tumors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkkuLFDEUhYMoTtv6E5SA6K7KPKpSycZhGHzBgAt1HdKpmzZlPbqTVGv_e1N04cBshEAI-e5J7jkXoZeUlJRQ8a4rzdDFOexLRogsiSoJJ4_QhspGFVRK_hhtCCGsUIKSK_Qsxi4fKa34U3RFVSUZq9UGHW_wIUzxADb5E-BpFyGcTPLTaHoc09yeMfwxgx_9uMfH2fQ-nfHkcO8dYD_iQ2ZhTBH_9uknHvL9fjRjwnsTU_AWT3PqIS26Kcx20X2OnjjTR3ix7lv04-OH77efi7uvn77c3twVtmpEKmpHrSIChBNCUmkbVtUVc4y0ra0E5420ztS8ZkZWqrW2bqEhQnGm3I7XHPgWvb3o5v6OM8SkBx8t9L0ZYZqjFk1FhahZBl8_ALtpDrn_qKlilayVynZuUX2hbLYrBnD6EPxgwllTopdEdKfXRPSSiCZK50Ry3atVfd4N0N5XrRFk4M0KmGhN74IZrY__OEYbImmzcNcXDrJpJw9BR5utt9D6kNPT7eT_-5X3DxRsn4PNj_6CM8T7rnVkmuhvy_gs00NkXrKR_C8sV8LG</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Schmidt, Carl, M.D</creator><creator>Gerdes, Hans, M.D</creator><creator>Hawkins, William, M.D</creator><creator>Zucker, Erica, B.A</creator><creator>Zhou, Qin, M.A</creator><creator>Riedel, Elyn, M.S</creator><creator>Jaques, David, M.D</creator><creator>Markowitz, Arnold, M.D</creator><creator>Coit, Daniel, M.D</creator><creator>Schattner, Mark, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090701</creationdate><title>A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction</title><author>Schmidt, Carl, M.D ; Gerdes, Hans, M.D ; Hawkins, William, M.D ; Zucker, Erica, B.A ; Zhou, Qin, M.A ; Riedel, Elyn, M.S ; Jaques, David, M.D ; Markowitz, Arnold, M.D ; Coit, Daniel, M.D ; Schattner, Mark, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-5f1c906e6f66818c724542f20ddc463378cfa5352a849dcc5de7069329fb353e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdomen</topic><topic>Abdominal neoplasm</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Decision making</topic><topic>Disease Progression</topic><topic>Dysphagia</topic><topic>Endoscopy</topic><topic>Endoscopy, Gastrointestinal</topic><topic>Fatalities</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Food intake</topic><topic>Gastric cancer</topic><topic>Gastric outlet obstruction</topic><topic>Gastric Outlet Obstruction - etiology</topic><topic>Gastric Outlet Obstruction - psychology</topic><topic>Gastric Outlet Obstruction - surgery</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Neoplasms - complications</topic><topic>Gastrointestinal Neoplasms - epidemiology</topic><topic>Gastrointestinal Neoplasms - psychology</topic><topic>General aspects</topic><topic>Humans</topic><topic>Implants</topic><topic>Intervention</topic><topic>Laparoscopy</topic><topic>Life expectancy</topic><topic>Life span</topic><topic>Malignancy</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>New York - epidemiology</topic><topic>Observational studies</topic><topic>Ostomy</topic><topic>Pain</topic><topic>Palliation</topic><topic>Palliative care</topic><topic>Palliative Care - methods</topic><topic>Patients</topic><topic>Polyethylene glycol</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Quality assessment</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Stent</topic><topic>Stents</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Studies</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmidt, Carl, M.D</creatorcontrib><creatorcontrib>Gerdes, Hans, M.D</creatorcontrib><creatorcontrib>Hawkins, William, M.D</creatorcontrib><creatorcontrib>Zucker, Erica, B.A</creatorcontrib><creatorcontrib>Zhou, Qin, M.A</creatorcontrib><creatorcontrib>Riedel, Elyn, M.S</creatorcontrib><creatorcontrib>Jaques, David, M.D</creatorcontrib><creatorcontrib>Markowitz, Arnold, M.D</creatorcontrib><creatorcontrib>Coit, Daniel, M.D</creatorcontrib><creatorcontrib>Schattner, Mark, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmidt, Carl, M.D</au><au>Gerdes, Hans, M.D</au><au>Hawkins, William, M.D</au><au>Zucker, Erica, B.A</au><au>Zhou, Qin, M.A</au><au>Riedel, Elyn, M.S</au><au>Jaques, David, M.D</au><au>Markowitz, Arnold, M.D</au><au>Coit, Daniel, M.D</au><au>Schattner, Mark, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>198</volume><issue>1</issue><spage>92</spage><epage>99</epage><pages>92-99</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background Gastric outlet obstruction (GOO) often complicates advanced malignancy. Palliative options include surgical bypass, endoscopic stent, percutaneous gastrostomy (PEG), or percutaneous jejunostomy (PEJ). Methods We enrolled 50 patients with GOO secondary to unresectable primary or metastatic cancer in a study examining palliative interventions. Validated instruments assessed quality of life (QOL) at baseline, 1 month, and 3 months following intervention. Results Median overall survival was 64 days. A shorter hospital stay and trend to lower mortality were observed after stent placement; solid food intake and rates of secondary intervention were comparable. Both stent and surgical bypass were associated with acceptable QOL outcomes. Fifteen patients refused participation at 1 month and 28 died of disease before 3 months, so 10 patients completed all surveys. Conclusions Although malignant GOO is associated with poor survival, there are reasonable alternatives for palliation. QOL studies are difficult to complete in this population due to severity of illness and short life expectancy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19482259</pmid><doi>10.1016/j.amjsurg.2008.09.030</doi><tpages>8</tpages></addata></record> |
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| subjects | Abdomen Abdominal neoplasm Biological and medical sciences Cancer Decision making Disease Progression Dysphagia Endoscopy Endoscopy, Gastrointestinal Fatalities Female Follow-Up Studies Food intake Gastric cancer Gastric outlet obstruction Gastric Outlet Obstruction - etiology Gastric Outlet Obstruction - psychology Gastric Outlet Obstruction - surgery Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Neoplasms - complications Gastrointestinal Neoplasms - epidemiology Gastrointestinal Neoplasms - psychology General aspects Humans Implants Intervention Laparoscopy Life expectancy Life span Malignancy Medical prognosis Medical sciences Metastases Metastasis New York - epidemiology Observational studies Ostomy Pain Palliation Palliative care Palliative Care - methods Patients Polyethylene glycol Prognosis Prospective Studies Quality assessment Quality of Life Questionnaires Stent Stents Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Studies Surgery Surgical implants Survival Survival Rate Time Factors Tumors |
| title | A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction |
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