title: Can Endoscopic Bleeding Control Improve the Prognosis of Advanced Gastric Cancer Patients?: A Retrospective Case-Control Study.
abstract: BACKGROUND
  Gastric bleeding is not rare and difficult to treat in gastric cancer patients. We investigated whether this affects survival and if successful bleeding control improves the prognosis.
  
  
  METHODS
  We retrospectively reviewed medical records for 64 subjects who underwent endoscopic therapy for gastric cancer bleeding at Asan Medical Center from January 2012 to December 2014 (bleeding group). Each subject was matched 1:2 by age, sex, and American Joint Committee on Cancer staging with 128 randomly selected patients treated for stomach cancer during the same period (control group). Median survival, bleeding treatment methods, successful bleeding control, and rebleeding rate were investigated.
  
  
  RESULTS
  The median age was 58.5 years, the male to female ratio 4.3:1. The initial hemostasis rate was 73.4%. Most patients were treated with a single method (37 patients, 57.8%); the coagrasper (32/95 cases, 33.7%) was the most frequently used treatment. Among the 47 patients in which successful bleeding control was achieved, 17 (36.2%) experienced rebleeding after 3 days. The median survival was longer in the control than in the bleeding group (18.5 vs. 6.5 mo), and in the successful bleeding control than in the failed bleeding control group (8.5 vs. 1.8 mo). However, the successful bleeding control group had lower survival than the control group (18.5 vs. 8.5 mo). Multivariate analysis showed that the risk of bleeding was lower in Borrmann type II, IV cancer, but was higher in the patients using antiplatelet or anticoagulant.
  
  
  CONCLUSIONS
  Successful bleeding control is essential for improving survival in bleeding gastric cancer patients.
authors: Departments of *Internal Medicine †Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Hyungchul
authors: H
authors: Park
authors: Ji Yong
authors: JY
authors: Ahn
authors: Hwoon-Yong
authors: HY
authors: Jung
authors: Joo Hyun
authors: JH
authors: Chun
authors: Kwangwoo
authors: K
authors: Nam
authors: Jeong Hoon
authors: JH
authors: Lee
authors: Kee Wook
authors: KW
authors: Jung
authors: Do Hoon
authors: DH
authors: Kim
authors: Kee Don
authors: KD
authors: Choi
authors: Ho June
authors: HJ
authors: Song
authors: Gin Hyug
authors: GH
authors: Lee
authors: Jin-Ho
authors: JH
authors: Kim
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis; D016896:Treatment Outcome