Inoperable adenocarcinoma of the oesophagogastric junction

Autor: O.J. Rämö, J.A. Salo, T. Pentikäinen, Eero Sihvo, M.E. Luostarinen
Jazyk: angličtina
Rok vydání: 2002
Předmět:
Male
medicine.medical_specialty
Palliative care
Esophageal Neoplasms
medicine.medical_treatment
Adenocarcinoma
inoperable adenocarcinoma
03 medical and health sciences
0302 clinical medicine
cost analysis
medicine
Humans
Esophagus
Aged
Neoplasm Staging
Retrospective Studies
Aged
80 and over
Esophageal disease
business.industry
Mortality rate
Palliative Care
Retrospective cohort study
General Medicine
Length of Stay
Middle Aged
medicine.disease
self-expanding metallic stents
Dysphagia
3. Good health
Surgery
laser coagulation
Treatment Outcome
medicine.anatomical_structure
Oncology
oesophagogastric junction
030220 oncology & carcinogenesis
Costs and Cost Analysis
Female
Stents
030211 gastroenterology & hepatology
Esophagogastric Junction
Esophagoscopy
medicine.symptom
Deglutition Disorders
business
Laser coagulation
Zdroj: Sihvo, E I T, Pentikäinen, T, Luostarinen, M E, Rämö, O J & Salo, J A 2002, ' Inoperable adenocarcinoma of the oesophagogastric junction : A comparative clinical study of laser coagulation versus self-expanding metallic stents with special reference to cost analysis ', European Journal of Surgical Oncology, vol. 28, no. 7, pp. 711-715 . https://doi.org/10.1053/ejso.2002.1315
ISSN: 1532-2157
0748-7983
DOI: 10.1053/ejso.2002.1315
Popis: Aims: Neither clinical nor financial comparisons yet exist between self-expanding metallic stents (SEMS) and laser therapy, concentrating on the treatment of obstructive adenocarcinomas of the oesophagogastric junction. The aim of our study was to compare the relative lifetime costs and clinical results of the Nd:YAG laser to those of SEMS as alternative forms of primary palliation of dysphagia for adenocarcinoma near the oesophagogastric junction.Methods:Fifty-two patients with distal oesophageal or oesophagogastric adenocarcinomas underwent palliative treatment for dysphagia: 32 treated with laser therapy and 20 with SEMS in this retrospective study. The clinical outcome and real cumulative costs as physical units and in financial terms were analysed for these study groups.Results: Although patients palliated with SEMS underwent fewer procedures (1.9±1.6 vs 3.4±4.0, P=0.0048) and spent less time in endoscopic theatre (38±25 min vs 118±152 min, P=0.0048), they spent as many days in hospital (12.9 vs 15.1, P=0.370) and required as high overall costs for therapy (5360 EUR vs 5450 EUR, P=0.679) as those treated with laser therapy. In addition, they had higher morbidity rates (30 vs 6.3%, P=0.043), hospital mortality (20 vs 3.1%, P=0.066), and 30-day mortality (40 vs 3.1%, P=0.0011) than did patients with laser therapy, with no evidence of SEMS being the more effective treatment modality.Conclusions: In patients with adenocarcinoma at the distal oesophagus or at the oesophagogastric junction, laser therapy palliates dysphagia effectively with lower morbidity and mortality rates and without increased costs or hospital stays than does use of self-expanding metallic stents.
Databáze: OpenAIRE
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