The role of the outpatient clinic in chemotherapy for patients with unresectable or recurrent gastric cancer.
BACKGROUND
Recently, outpatient chemotherapy centers have become popular in Japan. To clarify the actual conditions of outpatient clinics, we surveyed entire clinical courses of chemotherapy in patients with unresectable or recurrent gastric cancer.


METHODS
From the medical records of 64 patients with unresectable or recurrent gastric cancer with no prior chemotherapy, we obtained data on overall survival, non-hospitalized survival, the number of and reasons for attendance at the outpatient clinic and hospitalization, and medical conditions at discharge.


RESULTS
The median follow-up time was 520 days, the median survival time was 353 days, and the median non-hospitalized survival time was 282 days. Patients attended the outpatient clinic 1917 times in total; 145 (8%) of these were unplanned visits for accidental disease, disease progression, or toxicity. Patients were hospitalized 291 times in total: 110 (38%) of hospitalizations were unplanned or emergencies because of disease progression or toxicity. Patients were discharged 290 times in total; in 56 of these discharges (19%) unresolved medical problems remained, such as toxicity, total parenteral nutrition, or symptoms related to cancer. Three patients (5%) died from treatment-related leucopenia and thrombocytopenia.


CONCLUSIONS
Patients with unresectable and recurrent gastric cancer were treated at outpatient clinics for periods up to 80% longer than the entire clinical course of chemotherapy. However, there were some unplanned or emergency hospitalizations and some patients still experienced medical problems at discharge. The role of the outpatient clinic is very important to chemotherapy for patients with unresectable or recurrent gastric cancer.
Yamazaki
Kentaro
K
Division of Gastrointestinal Oncology and Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan. k.yamazaki@scchr.jp
Boku
Narikazu
N
Shibamoto
Kaoru
K
Yasui
Hirofumi
H
Fukutomi
Akira
A
Yoshino
Takayuki
T
Hironaka
Shuichi
S
Onozawa
Yusuke
Y
Otake
Yosuke
Y
Hasuike
Noriaki
N
Matsubayashi
Hiroyuki
H
Inui
Tetsuya
T
Yamaguchi
Yuichiro
Y
Ono
Hiroyuki
H
D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002173:Cancer Care Facilities; D004632:Emergency Medical Services; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy*; D016019:Survival Analysis
D000970:Antineoplastic Agents