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Carcinomatosis matters: clinical outcomes and prognostic factors for clinical success of stent placement in malignant gastric outlet obstruction

Title
Carcinomatosis matters: clinical outcomes and prognostic factors for clinical success of stent placement in malignant gastric outlet obstruction
Author
박찬혁
Keywords
Ascites; Carcinomatosis; Gastric outlet obstruction; Self-expandable metallic stent; SEMS
Issue Date
2014-03
Publisher
Springer Science + Business Media
Citation
Surgical endoscopy, 2014, 28(3), P.988-995
Abstract
Although carcinomatosis is not a contraindication to stenting in selected patients with malignant gastric outlet obstruction (GOO), associate factors for clinical success rate of self-expandable metallic stent (SEMS) placement in GOO patients with carcinomatosis have not been fully characterized.We analyzed a total 228 patients who were scheduled for SEMS placement for malignant GOO in tertiary-care academic medical center. All patients were treated with an uncovered or covered SEMS by using the over-the-wire placement procedure. We retrospectively evaluated clinical outcomes of SEMS placement.Technical success was achieved in all patients. Patients were categorized into two groups according to the presence of carcinomatosis. Clinical success rates of patients without carcinomatosis group and with carcinomatosis group were 93.9 % (92 of 98) and 80.8 % (105 of 130), respectively (P = 0.004). In subgroup analysis of patients with carcinomatosis, the clinical success rate was lower in patients with ascites (64.8 %) than in those without ascites (92.1 %, P < 0.001). Multivariate logistic regression model revealed that carcinomatosis without ascites did not decrease clinical success rate compared with absence of carcinomatosis; meanwhile, carcinomatosis with ascites showed lower clinical success rates compared with absence of carcinomatosis (adjusted odds ratio 0.163, 95 % confidence interval 0.058-0.461). In addition, poor performance status [Eastern Cooperative Oncology Group (ECOG) status a parts per thousand yen3, adjusted odds ratio 0.178, 95 % confidence interval 0.078-0.409] was also an independent poor predictive factor for clinical success of SEMS placement.In palliation for malignant GOO, the status of carcinomatosis with ascites and poor performance status (ECOG status a parts per thousand yen3) are significant predictive factors for poor clinical success of SEMS placement.
URI
https://link.springer.com/article/10.1007%2Fs00464-013-3268-x
ISSN
0930-2794; 1432-2218
DOI
10.1007/s00464-013-3268-x
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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