Predictive factors of solid food intake in patients with malignant gastric outlet obstruction receiving self-expandable metallic stents for palliation.
OBJECTIVE
As for self-expandable metallic stents (SEMS) for malignant gastric outlet obstruction (GOO), some predictive factors of stent patency have been reported, although re-canalization of GOO by SEMS does not necessarily lead to favorable food intake. Therefore, we analyzed the predictive factors of oral food intake following SEMS placement.


METHODS
A total of 97 consecutive patients in whom SEMS were placed for malignant GOO in five hospitals were included in this retrospective study. Clinical outcomes and predictive factors influencing solid food intake were analyzed.


RESULTS
The technical and clinical success rates were 97.9% and 87.6%, respectively. The mean gastric outlet obstruction scoring system (GOOSS) improved from 0.39 to 2.24 after SEMS placement (P<0.01). The median eating period was 2.1 months (95% CI, 1.1-3.0 months), and the median survival time was 3.1 months (95% CI, 2.0-4.2 months). A Karnofsky performance status of ≤ 50 (odds ratio, 3.65; 95% CI, 1.17-13.1; P=0.03) and ascites (odds ratio, 3.28; 95% CI, 1.23-9.05; P=0.02) were identified as statistically significant independent poor predictive factors of solid food intake.


CONCLUSIONS
SEMS is an effective treatment for patients with malignant GOO. Ascites and a poor performance status were poor predictive factors of solid food intake.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo Department of Gastroenterology, Tokyo, Japan.
Takashi
T
Sasaki
Hiroyuki
H
Isayama
Yousuke
Y
Nakai
Osamu
O
Togawa
Hirofumi
H
Kogure
Kazumichi
K
Kawakubo
Suguru
S
Mizuno
Yoko
Y
Yashima
Yukiko
Y
Ito
Natsuyo
N
Yamamoto
Naoki
N
Sasahira
Kenji
K
Hirano
Takeshi
T
Tsujino
Nobuo
N
Toda
Minoru
M
Tada
Masao
M
Omata
Kazuhiko
K
Koike
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000150:complications; D004435:Eating; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000150:complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications