A prospective observational study examining quality of life in patients with malignant gastric outlet obstruction.
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.
Schmidt
Carl
C
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Gerdes
Hans
H
Hawkins
William
W
Zucker
Erica
E
Zhou
Qin
Q
Riedel
Elyn
E
Jaques
David
D
Markowitz
Arnold
A
Coit
Daniel
D
Schattner
Mark
M
D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000523:psychology* / Q000601:surgery; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D009518:New York / Q000453:epidemiology; D010166:Palliative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate; D013997:Time Factors