Endoscopic treatment of malignant gastric and duodenal strictures: a prospective, multicenter study
Malignant gastric outlet obstruction is often treated by stent placement. To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Prospective, observational, multicenter registry. Six tertiary care centers in 5 countries. A total of 108 adult patients with...
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| Published in | Gastrointestinal endoscopy Vol. 79; no. 1; pp. 66 - 75 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.01.2014
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Malignant gastric outlet obstruction is often treated by stent placement.
To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms.
Prospective, observational, multicenter registry.
Six tertiary care centers in 5 countries.
A total of 108 adult patients with malignant gastric outlet obstruction.
Placement of an uncovered, self-expandable, metal duodenal stent.
The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant).
Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days).
Observational study, no control group.
Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614.) |
|---|---|
| AbstractList | Malignant gastric outlet obstruction is often treated by stent placement.
To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms.
Prospective, observational, multicenter registry.
Six tertiary care centers in 5 countries.
A total of 108 adult patients with malignant gastric outlet obstruction.
Placement of an uncovered, self-expandable, metal duodenal stent.
The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant).
Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days).
Observational study, no control group.
Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (
NCT00991614.). Background Malignant gastric outlet obstruction is often treated by stent placement. Objective To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Design Prospective, observational, multicenter registry. Setting Six tertiary care centers in 5 countries. Patients A total of 108 adult patients with malignant gastric outlet obstruction. Interventions Placement of an uncovered, self-expandable, metal duodenal stent. Main Outcome Measurements The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). Results Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). Limitations Observational study, no control group. Conclusions Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614 .) Malignant gastric outlet obstruction is often treated by stent placement. To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Prospective, observational, multicenter registry. Six tertiary care centers in 5 countries. A total of 108 adult patients with malignant gastric outlet obstruction. Placement of an uncovered, self-expandable, metal duodenal stent. The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). Observational study, no control group. Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614.) Malignant gastric outlet obstruction is often treated by stent placement.BACKGROUNDMalignant gastric outlet obstruction is often treated by stent placement.To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms.OBJECTIVETo investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms.Prospective, observational, multicenter registry.DESIGNProspective, observational, multicenter registry.Six tertiary care centers in 5 countries.SETTINGSix tertiary care centers in 5 countries.A total of 108 adult patients with malignant gastric outlet obstruction.PATIENTSA total of 108 adult patients with malignant gastric outlet obstruction.Placement of an uncovered, self-expandable, metal duodenal stent.INTERVENTIONSPlacement of an uncovered, self-expandable, metal duodenal stent.The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant).MAIN OUTCOME MEASUREMENTSThe primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant).Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days).RESULTSTechnical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days).Observational study, no control group.LIMITATIONSObservational study, no control group.Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (CONCLUSIONSDuodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (NCT00991614.).CLINICAL TRIAL REGISTRATION NUMBERNCT00991614.). |
| Author | Didden, Paul Johnston, Krystal Perri, Vincenzo Mutignani, Massimiliano Bourke, Michael J. Spicak, Julius Costamagna, Guido Roy, André Drastich, Pavel Tringali, Andrea Spaander, Manon Williams, Stephen J. Repici, Alessandro |
| Author_xml | – sequence: 1 givenname: Andrea surname: Tringali fullname: Tringali, Andrea organization: Digestive Endoscopy Unit, Catholic University, Rome, Italy – sequence: 2 givenname: Paul surname: Didden fullname: Didden, Paul organization: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands – sequence: 3 givenname: Alessandro surname: Repici fullname: Repici, Alessandro organization: Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Milan, Italy – sequence: 4 givenname: Manon surname: Spaander fullname: Spaander, Manon organization: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands – sequence: 5 givenname: Michael J. surname: Bourke fullname: Bourke, Michael J. organization: Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia – sequence: 6 givenname: Stephen J. surname: Williams fullname: Williams, Stephen J. organization: Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia – sequence: 7 givenname: Julius surname: Spicak fullname: Spicak, Julius organization: Department of Hepatogastroenterology, IKEM, Prague, Czech Republic – sequence: 8 givenname: Pavel surname: Drastich fullname: Drastich, Pavel organization: Department of Hepatogastroenterology, IKEM, Prague, Czech Republic – sequence: 9 givenname: Massimiliano surname: Mutignani fullname: Mutignani, Massimiliano organization: Digestive Endoscopy Unit, Catholic University, Rome, Italy – sequence: 10 givenname: Vincenzo surname: Perri fullname: Perri, Vincenzo organization: Digestive Endoscopy Unit, Catholic University, Rome, Italy – sequence: 11 givenname: André surname: Roy fullname: Roy, André organization: Endoscopy Unit, Centre Hospitalier de l'Université de Montreal (CHUM), Hôpital Saint-Luc, Montréal Québec, Canada – sequence: 12 givenname: Krystal surname: Johnston fullname: Johnston, Krystal organization: MED Institute, Inc, West Lafayette, Indiana, USA – sequence: 13 givenname: Guido surname: Costamagna fullname: Costamagna, Guido organization: Digestive Endoscopy Unit, Catholic University, Rome, Italy |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23932009$$D View this record in MEDLINE/PubMed |
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| Copyright | 2014 American Society for Gastrointestinal Endoscopy American Society for Gastrointestinal Endoscopy Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
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| Snippet | Malignant gastric outlet obstruction is often treated by stent placement.
To investigate the outcomes of stent placement in the palliative treatment of... Background Malignant gastric outlet obstruction is often treated by stent placement. Objective To investigate the outcomes of stent placement in the palliative... Malignant gastric outlet obstruction is often treated by stent placement.BACKGROUNDMalignant gastric outlet obstruction is often treated by stent placement.To... |
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| SubjectTerms | Adult Aged Aged, 80 and over Digestive System Neoplasms - complications Endoscopy, Gastrointestinal - adverse effects Female Gastric Outlet Obstruction - etiology Gastric Outlet Obstruction - therapy Gastroenterology and Hepatology Humans Male Middle Aged Palliative Care Prospective Studies Severity of Illness Index Stents - adverse effects Time Factors Treatment Outcome |
| Title | Endoscopic treatment of malignant gastric and duodenal strictures: a prospective, multicenter study |
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