Endoscopic duodenal stent placement versus gastrojejunostomy for unresectable pancreatic cancer patients with duodenal stenosis before introduction of initial chemotherapy (GASPACHO study): a multicenter retrospective study. (29th December 2021)

• Record Type: Journal Article
• Authors: Azemoto, Nobuaki; Ueno, Makoto; Yanagimoto, Hiroaki; Mizuno, Nobumasa; Kawamoto, Yasuyuki; Maruki, Yuta; Watanabe, Kazuo; Suzuki, Rei; Kaneko, Junichi; Hisada, Yuya; Sato, Hiroki; Kobayashi, Satoshi; Miyata, Hideki; Furukawa, Masayuki; Mizukami, Takuro; Miwa, Haruo; Ohno, Yoshinori; Tsuji, Kunihiro; Tsujimoto, Akiko; Nagano, Hiroaki; Okuyama, Hiroyuki; Asagi, Akinori; Okano, Naohiro; Ishii, Hiroshi; Morizane, Chigusa; Ikeda, Masafumi; Furuse, Junji
• Is Part Of: Japanese journal of clinical oncology. Volume 52:Number 2(2022)
• Page Start: 134
• Page End: 142
• Publication Date: 2021-12-29
• Subjects: chemotherapy -- gastric bypass surgery -- gastric outlet obstruction -- metallic stent -- pancreatic cancer; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyab194
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract: Background: Endoscopic duodenal stent placement is an alternative technique to gastrojejunostomy for gastric outlet obstruction due to pancreatic cancer. We compared the efficacy of endoscopic duodenal stent placement with that of gastrojejunostomy for treating patients with pancreatic cancer who are candidates for intensive combination chemotherapies as the first line of treatment. Methods: This retrospective observational study included 100 patients from 18 institutions in Japan. Inclusion criteria were as follows: (1) cytologically or histologically confirmed adenocarcinoma of the pancreas, (2) good performance status, (3) gastric outlet obstruction scoring system score of 0–1 and (4) no history of treatment for pancreatic cancer. Results: There was no significant difference in the background characteristics of patients in the endoscopic duodenal stent placement ( n = 57) and gastrojejunostomy ( n = 43) groups. The median overall survival in the endoscopic duodenal stent placement and gastrojejunostomy groups was 5.9 and 6.0 months, respectively. Clinical success was achieved in 93 cases; the median time to food intake resumption was significantly shorter in the endoscopic duodenal stent placement group (median: 3 days, n = 54) than in the gastrojejunostomy group (median: 5 days, n = 43). Chemotherapy was introduced in 63% of the patients in both groups after endoscopic duodenal stent placement or gastrojejunostomy. Chemotherapy was started earlier in the endoscopic duodenal stent placement group (median: 14 days) than in the gastrojejunostomy (median: 32 days) group. Conclusions: Endoscopic duodenal stent placement showed similar or better clinical outcomes than gastrojejunostomy. Thus, it might be a promising option in patients with good performance status. Abstract : Endoscopic duodenal stent placement could be a promising alternative intervention in patients with good performance status.