Neoplasms

Digestive System Diseases

All Conditions

Nutritional and Metabolic Diseases

Symptoms and General Pathology

Nervous System Diseases

Rare Diseases

Behaviors and Mental Disorders

Esophageal Neoplasms

Stomach Neoplasms

Obesity

Sarcopenia

Obesity, Abdominal

Overweight

Overnutrition

Nutrition Disorders

Body Weight

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Muscular Atrophy

Atrophy

Neuromuscular Manifestations

Neurologic Manifestations

Pathological Conditions, Anatomical

Esophageal Cancer

Quality of Life

Stomach Cancer

Esophagectomy or Gastrectomy

John V Reynolds, MCh FRCS

In line with improvements in oncologic outcome for patients with esophageal cancer, the attritional impact of curative treatment with respect to functional status and health-related quality of life (HR-QL) in survivorship is increasingly an important focus. Functional recovery after surgery for esophageal cancer is commonly confounded by anorexia and early satiety, which may reduce oral nutrient intake with consequent malnutrition and weight loss. One in three disease-free patients has more than fifteen percent body weight loss at three years after esophagectomy.

The ESPEN Special Interest Group on cachexia-anorexia in chronic wasting diseases has defined sarcopenia as skeletal muscle index (SMI) of ≤39 cm2/m2 for women and ≤55cm2/m2 for men, while similar cut-off points have been validated in upper gastrointestinal and respiratory malignancies (less than 38.5 cm2/m2 for women and 52.4 cm2/m2 for men). The European Working Group on Sarcopenia in Older People (EWGSOP) additionally recommends that assessment should also include determination of muscle function, for example gait speed or grip strength, where possible.

The presence of sarcopenia is associated with increase treatment-associated morbidity, impaired HR-QL, reduced physical and role functioning, and increased pain scores in older adults. In addition, a previous longitudinal study demonstrated that the decline in HR-QL over a six year period in older adults was accelerated in the presence of sarcopenia. As such, sarcopenia may represent a modifiable barrier to recovery and subsequent retention of HR-QL and functional status, and may reinforce a persistent illness identity, among patients following potentially curative treatment for esophageal cancer.

Sarcopenia and Visceral Obesity in Esophageal and Gastric Cancer

An Investigation of the Prevalence and Clinical Impact of Sarcopenia and Visceral Obesity Among Patients With Upper Gastrointestinal Malignancies

St. James's Hospital, Ireland

Clinical Research Fellow

Colonic Neoplasms

Intestinal Obstruction

Colorectal Neoplasms

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Herbal and Botanical

All Drugs and Chemicals

Cola

Neoadjuvant chemotherapy was administered 1 week after successful SEMS placement and decompression for patient with obstructing left-sided colonic cancer. Patients received either three cycles of mFOLFOX6 repeated every 2 weeks or two cycles of CAPOX repeated every 3 weeks. Elective surgery was performed 2 weeks after completion of chemotherapy by experienced colorectal surgeons.

self-expanding metallic stent placement followed by neoadjuvant chemotherapy

This study aimed to evaluate the safety and feasibility of SEMS followed by neoadjuvant chemotherapy prior to elective surgery for obstructing left-sided colon cancer.

Stoma is reported to be frequent in self-expanding metallic stent (SEMS) treated patients with obstructing left-sided colon cancer than in those with non-obstructing surgery. Retrospective study reported worse overall survival with SEMS and elective surgery than with emergency surgery in patients with left-sided malignant colon obstruction. In practice, intestinal wall edema following stent placement increases the difficulty of surgery, and this could be a major problem if the interval between stent insertion and surgery is short (1-2 weeks). The patients with obstructing left-sided colon cancer received SEMS treatment, and the recevied neoadjuvant chemotherapy prior to elective surgery.

SEMS Placement Followed by Chemotherapy and Surgery for Obstructing Left-sided Colonic Cancer

Self-expanding Metallic Stent Placement Followed by Neoadjuvant Chemotherapy and Scheduled Surgery for Treatment of Obstructing Left-sided Colonic Cancer

Beijing Chao Yang Hospital

Chairman of General Surgery

Adenoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

performed pancreatic duct stent placement after endoscopic papillectomy

have not performed pancreatic duct stent placement after endoscopic papillectomy

performed common bile duct stent placement after endoscopic papillectomy

have not performed common bile duct stent placement after endoscopic papillectomy

Post-resection, endoscopic retrograde cholangiopancreatography (ERCP) was performed for stent placement in pancreatic or bile ducts as needed, with X-ray confirmation of stent positioning.

Stent Placement in Pancreatic and Bile Ducts

Fujing Lv, M.D.

This is a retrospective study, including 79 patients with duodenal papillary adenoma, who treated with Endoscopic Papillectomy (EP) at Beijing friendship hospital. The cohort included patients who underwent EP with or without Pancreatic Duct (PD) and Common Bile Duct (CBD) stent placement. The investigators assessed the outcomes of EP and the impact of stent placement on complications and recurrence rates.

Duodenal papillary adenoma, a potentially malignant benign tumor is primarily treated with endoscopic papillectomy. Despite its efficacy, endoscopic papillectomy has a high complication rate. This study investigates whether pancreatic duct and common bile duct stent placement can mitigate these complications. In a retrospective analysis, 79 patients with duodenal papillary adenoma, treated with endoscopic papillectomy at our center, were studied. The cohort included patients who underwent endoscopic papillectomy with no stents placement, common bile duct stent placement alone, pancreatic duct stent placement alone, or stents placement in both ducts. Complete resection rates did not significantly differ between patients with or without stent placement. Early complication rates were similar across groups. However, significant reduction in common bile duct stenosis was observed in the stenting group. Furthermore, stent placement correlated with lower adenoma recurrence rates during follow-up. Thus, Pancreatic duct and common bile duct stent placement in endoscopic papillectomy may decrease late complications, particularly common bile duct stenosis, and reduce the recurrence of duodenal papillary adenoma.

Effectiveness of Endoscopic Papillectomy With Stent for Treating Duodenal Papillary Adenoma

Effectiveness of Endoscopic Papillectomy With Stent Placement in Pancreatic and Bile Ducts for Treating Duodenal Papillary Adenoma

Complications related with Endoscopic Papillectomy (EP), including pancreatitis, cholangitis, bleeding, perforation, hyperamylasemia, stenosis. The results of intraoperative endoscopic observation, postoperative symptoms and signs, blood routine examination, amylase, lipase, and imaging and endoscopic examination during follow-up were measured.

The pathological margins results were used to determine whether the lesion was completely resected.

Endoscopic observation and biopsy results were used to find recurrence.

Beijing Friendship Hospital

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Sarcopenia and Visceral Obesity in Esophageal and Gastric Cancer	NCT03061370	Esophageal Canc... Gastric Cancer Sarcopenia Sarcopenic Obes... Obesity Visceral Obesit... Quality of Life Surgery Complication of... Chemotherapeuti... Physical Activi... Oncology	Esophagectomy o...	18 Years -	St. James's Hospital, Ireland
SEMS Placement Followed by Chemotherapy and Surgery for Obstructing Left-sided Colonic Cancer	NCT04039360	Complication of...	self-expanding ...	18 Years - 80 Years	Beijing Chao Yang Hospital
Effectiveness of Endoscopic Papillectomy With Stent for Treating Duodenal Papillary Adenoma	NCT06301048	Duodenal Adenom... Complication of...	Stent Placement...	18 Years -	Beijing Friendship Hospital

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