Endoscopic palliative treatment for esophageal and gastric cancer: techniques, complications, and survival in a population-based cohort of 948 patients.
BACKGROUND
Under the auspices of the Scottish Audit of Gastric and Esophageal Cancer, we investigated treatment techniques, complications, and survival in a population-based cohort of patients undergoing endoscopic palliative therapy for esophageal or gastric cancer.


METHODS
A total of 948 patients undergoing endoscopic palliative therapy were identified prospectively and followed for a minimum of 1 year.


RESULTS
Expandable metal stent placement (506 patients) and LASER (117 patients) were the most frequently used treatment options. Stent placement was more common for grade 3 or 4 dysphagia. Delivery of endoscopic palliative therapy varied by region of residence (from 18% to 38% of patients, p < 0.001) but not by deprivation category. Complications were recorded in 16% of patients (155 of 948). Overall survival was 40% (95% confidence interval [CI], 36-43) at 6 months, 17% (95% CI, 14-19) at 12 months, and 10% (95% CI, 8-12%) at 18 months.


CONCLUSIONS
These data define the reality of endoscopic palliative therapy for patients with advanced esophageal or gastric cancer and provide a baseline against which future improvements in care can be measured.
Thompson
A M
AM
Department of Surgery and Molecular Oncology, University of Dundee, Ninewells Hospital and Medical School, DD1 9SY, Dundee, Scotland, United Kingdom. a.m.thompson@dundee.ac.uk
Rapson
T
T
Gilbert
F J
FJ
Park
K G M
KG
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D004943:Esophagogastric Junction; D004945:Esophagoscopy / Q000009:adverse effects; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D010166:Palliative Care / Q000379:methods; D011446:Prospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*