Severe Upper Gastrointestinal Tumor Bleeding: Endoscopic Findings, Treatment, and Outcome

Savides, Thomas J.; Jensen, Dennis M.; Cohen, Jack R.; Randall, Gayle; Kovacs, Thomas O.; Pelayo, Eileen; Cheng, Su-Ting; Jensen, Mary E.; Hsieh, Hui-Hsia

doi:10.1055/s-2007-1005436

Cited by 133 publications

(104 citation statements)

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“…For the treatment of gastric cancer bleeding, endoscopic hemostasis is accepted as the first-line treatment, and it has previously been proven in several studies to be an effective treatment for the hemostasis of gastric bleeding [5,6,8,16]. Even though endoscopic hemostasis is an effective method for gastric cancer bleeding, if an endoscopic approach for the bleeding lesion is difficult, or if the lesion has diffuse and massive bleeding, or if it has invaded a large main gastric vessel, it can be difficult to perform endoscopic hemostasis [7,13,14,17,18].…”

Section: Discussionmentioning

confidence: 99%

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The successful endoscopic hemostasis factors in bleeding from advanced gastric cancer

et al. 2012

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Background When patients with advanced gastric cancer experience active bleeding, gastroenterologists normally choose between two treatment modalities, endoscopic hemostasis and transarterial embolization (TAE). In patients with advanced gastric cancer with bleeding, the predictive factors for endoscopic hemostatic failure are still unknown. Thus, the purpose of this study was to evaluate predictive factors for endoscopic hemostasis failure and to differentiate which hemostasis procedure is more effective for advanced gastric cancer with bleeding. Methods We reviewed the medical records of patients who were diagnosed with advanced gastric cancer and acute non-variceal gastric bleeding from January 2006 to August 2011. Forty-five patients were enrolled in this study and they were divided into a group of 14 patients who had experienced successful endoscopic hemostasis and a group of 31 patients who had had unsuccessful hemostasis with the first endoscopy and then underwent TAE. Results Lesion size and bleeding condition of Forrest class 1a or 1b were statistically significant predictive factors for endoscopic hemostatic failure (P = 0.023 and P = 0.017, respectively). On multivariate logistic regression analysis, size (lesion [2 cm) was a significant predictive factor for endoscopic hemostatic failure [adjusted odds ratio (aOR) 8.056; 95 % confidence interval (CI) 1.329-48.846].Conclusions We determined that small bleeding lesions (\2 cm) and exposed vessels in the bleeding site with gastric cancer indicated that endoscopic hemostasis would be an effective hemostatic modality to choose. Particularly, in the opposite condition, the presence of large bleeding lesions ([2 cm) and non-exposed vessel bleeding with a tumor, endoscopic hemostasis failure is predicted and TAE could be recommended.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of gastric cancer with bleeding is reported to be about 1-8 % [6][7][8]. For this reason, it is very important to establish a proper treatment plan for patients with gastric cancer accompanied by bleeding.…”

Section: Introductionmentioning

confidence: 99%

The successful endoscopic hemostasis factors in bleeding from advanced gastric cancer

et al. 2012

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“…Virtually any tumor type may bleed. Patients with severe bleeding resulting from malignant upper gastrointestinal tumors show a poor prognosis, the majority of whom die within 12 months [46]. Radiotherapy in these cases is most often palliative.…”

Section: Radiotherapymentioning

confidence: 99%

Upper Gastrointestinal Bleeding in Oncological Patients

Alberti

Santos

Àlex

et al. 2016

GHOA

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Bleeding is a relatively common phenomenon in patients with solid neoplasms, occurring in up to 10% of all patients in advanced stages of cancer. Therefore, this study aims to discuss clinical support management, endoscopic strategies, radiotherapy, chemotherapy, as well as endovascular and surgical interventions. AbstractBleeding is a relatively common phenomenon in patients with solid neoplasms, occurring in up to 10% of all patients in advanced stages of cancer. The objective of this article is to review the etiology, clinical manifestations, and treatment of acute upper gastrointestinal bleeding in cancer patients, understanding that chronic and occult blood losses are not within the scope of this text. To achieve better outcomes in the management of this entity, a multidisciplinary approach is mandatory. Therefore, this study aims to discuss clinical support management, endoscopic strategies, radiotherapy, chemotherapy, as well as endovascular and surgical interventions.

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“…As such, endoscopy typically serves as first-line treatment for acute gastrointestinal hemorrhage, but has been reported be of more limited benefit of tumoral related hemorrhage because of high recurrence and complication rates [80,81].…”

Section: Trans-arterial Embolization For Uncontrolled Hemorrhagementioning

confidence: 99%

The role of interventional oncology in the palliative care of cancer patients

Hussaini

Kang

et al. 2016

Expert Review of Quality of Life in Cancer Care

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Interventional oncologists have expertise in delivery of state of the art, minimally invasive, imageguided procedures. As such, interventional oncologists are well-suited to provide palliative options for cancer patients, who often have complex comorbidities precluding them from more invasive options. The broad spectrum of procedures developed into clinical practice highlight the integral role of interventional oncology in the palliation of cancer patients. This review will focus on several of the more common procedures performed by interventional oncologists to provide symptomatic relief: 1. Tunneled peritoneal or pleural catheter placement for fluid drainage; Peritoneovenous shunt placement for fluid drainage; 2. Ablation with focus on metastatic bone ablation for pain control; 3. Neurolysis with focus on celiac neurolysis for pain control; 4. Decompressive gastrostomies or cecostomies for gastric and bowel obstruction; 5. Transarterial embolization for uncontrolled hemorrhage. A description of each procedure and its relative efficacy in providing palliation will be summarized. ARTICLE HISTORY

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Severe Upper Gastrointestinal Tumor Bleeding: Endoscopic Findings, Treatment, and Outcome

Cited by 133 publications

References 0 publications

The successful endoscopic hemostasis factors in bleeding from advanced gastric cancer

The successful endoscopic hemostasis factors in bleeding from advanced gastric cancer

Upper Gastrointestinal Bleeding in Oncological Patients

The role of interventional oncology in the palliative care of cancer patients

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