Natural history of acute upper <scp>GI</scp> bleeding due to tumours: short‐term success and long‐term recurrence with or without endoscopic therapy

Sheibani, Sarah; Kim, J. J.; Chen, B.; Park, S.; Saberi, Behnam; Keyashian, Kian; Buxbaum, James; Laine, Loren

doi:10.1111/apt.12347

Cited by 93 publications

(84 citation statements)

References 17 publications

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“…Among patients with upper gastrointestinal (UGI) malignancies, about 5% suffer from acute UGI bleeding (UGIB) [12]. Primary gastric cancer is the most common UGI malignancy causing UGIB [12].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Primary gastric cancer is the most common UGI malignancy causing UGIB [12]. Recurrent tumor bleeding after initially successful hemostasis using endoscopic therapy occurs in 41%–80% of patients with inoperable gastric cancer [234]. Tumor bleeding is a distressing complication because it may delay a predetermined chemotherapy schedule, increase the need for transfusion, and be associated with poor survival [45].…”

Section: Introductionmentioning

confidence: 99%

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Effect of a Proton Pump Inhibitor on Tumor Bleeding Prevention in Unresectable Gastric Cancer Patients: a Double-Blind, Randomized, Placebo-Controlled Trial

Kim

Park

et al. 2017

J Gastric Cancer

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PurposeTumor bleeding is a major complication in inoperable gastric cancer. The study aim was to investigate the effects of proton pump inhibitor (PPI) treatment for the prevention of gastric tumor bleeding.Materials and MethodsThis study was a prospective double-blind, randomized, placebo-controlled trial. Patients with inoperable gastric cancer were randomly assigned to receive oral lansoprazole (30 mg) or placebo daily. The primary endpoint was the occurrence of tumor bleeding, and the secondary endpoints were transfusion requirement and overall survival (OS).ResultsThis study initially planned to enroll 394 patients, but prematurely ended due to low recruitment rate. Overall, 127 patients were included in the analyses: 64 in the lansoprazole group and 63 in the placebo group. During the median follow-up of 6.4 months, tumor bleeding rates were 7.8% and 9.5%, in the lansoprazole and placebo groups, respectively, with the cumulative bleeding incidence not statistically different between the groups (P=0.515, Gray's test). However, during the initial 4 months, 4 placebo-treated patients developed tumor bleeding, whereas there were no bleeding events in the lansoprazole-treated patients (P=0.041, Gray's test). There was no difference in the proportion of patients who required transfusion between the groups. The OS between the lansoprazole (11.7 months) and the placebo (11.0 months) groups was not statistically different (P=0.610). Study drug-related serious adverse event or bleeding-related death did not occur.ConclusionsTreating patients with inoperable gastric cancer with lansoprazole did not significantly reduce the incidence of tumor bleeding. However, further studies are needed to evaluate whether lansoprazole can prevent tumor bleeding during earlier phases of chemotherapy (ClinicalTrial.gov, identifier No. NCT02150447).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of a Proton Pump Inhibitor on Tumor Bleeding Prevention in Unresectable Gastric Cancer Patients: a Double-Blind, Randomized, Placebo-Controlled Trial

Kim

Park

et al. 2017

J Gastric Cancer

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“…The endoscopic treatment of UGIB caused by tumors is particularly challenging because bleeding lesions tend to be large, with several oozing bleeds from fragile vessels (64). In such cases, endoscopic strategies may be only temporary, while a more definitive way of controlling bleeding such as surgery or radiotherapy is planned (65).…”

Section: Tumor-related Bleedingmentioning

confidence: 99%

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Cúrdia-Gonçalves¹,

Rosa²,

Cotter³

2016

Rev Esp Enferm Dig

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Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition and the most common medical emergency managed by gastroenterologists. Despite being one of the most antique medical problems, recent studies have been slowly changing the management of these patients, which should nowadays include not only initial resuscitation, but also risk stratification, pre-endoscopic therapy, endoscopy treatment, and post-procedure care. The aim of this paper is to review the extended approach to the patient with non-portal hypertension related UGIB.

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“…In the article by Sheibani et al ., additional data shed light on the outcomes of 106 patients who presented with upper gastrointestinal bleeding from tumours. There are two key results of note.…”

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confidence: 99%

Commentary: natural history and management of acute upper GI bleeding due to tumours

Kyaw

Chan

2013

Aliment Pharmacol Ther

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Compared with peptic ulcer bleeding, there is limited knowledge on the natural history of tumour-related bleeding and the use of endoscopic haemostasis in this setting. To date, only limited data from small case series 1, 2 are available.In the article by Sheibani et al., 3 additional data shed light on the outcomes of 106 patients who presented with upper gastrointestinal bleeding from tumours. There are two key results of note. The first is the high success rate of haemostasis at the index endoscopy (86%) and the second is the high rebleeding rate (49%), both of which are similar to previous studies.

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Natural history of acute upper GI bleeding due to tumours: short‐term success and long‐term recurrence with or without endoscopic therapy

Abstract: SUMMARY BackgroundScant information is available regarding patients with upper gastrointestinal bleeding (UGIB) from tumours.

Cited by 93 publications

References 17 publications

Effect of a Proton Pump Inhibitor on Tumor Bleeding Prevention in Unresectable Gastric Cancer Patients: a Double-Blind, Randomized, Placebo-Controlled Trial

Effect of a Proton Pump Inhibitor on Tumor Bleeding Prevention in Unresectable Gastric Cancer Patients: a Double-Blind, Randomized, Placebo-Controlled Trial

New insights on an old medical emergency: non-portal hypertension related upper gastrointestinal bleeding

Commentary: natural history and management of acute upper GI bleeding due to tumours

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