Endoscopic bleeding control improves prognosis of advanced gastric cancer patients
Successful endoscopic bleeding control can help improve survival in bleeding gastric cancer patients, suggests a recent study.
Researchers retrospectively reviewed medical records of 64 patients who underwent endoscopic therapy for gastric cancer bleeding (bleeding group) at Asan Medical Center from January 2012 to December 2014 to determine whether successful bleeding control improves prognosis.
Each patient 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). Researchers investigated the rebleeding rate, bleeding treatment methods, median survival and successful bleeding control.
The patients’ median age was 58.5 years, and the male-to-female ratio was 4:3:1. The initial haemostasis rate was 73.4 percent. Single method was used to treat most patients (n=37; 57.8 percent). The most frequently used treatment was the coagrasper (32/95 cases; 33.7 percent).
Seventeen (36.2 percent) of the 47 patients in which successful bleeding control was achieved experienced rebleeding after 3 days. Patients in the control group had longer median survival than those in the bleeding group (18.5 vs 6.5 months).
Furthermore, median survival was also longer in the successful bleeding control than in the failed bleeding control group (8.5 vs 1.8 months). However, patients in the successful bleeding control group had lower survival than those in the control group (18.5 vs 8.5 months).
Based on multivariate analysis, the risk of bleeding was lower in Borrmann type II, IV cancer but was higher in patients using antiplatelet or anticoagulant.