1 / 27

Management of premalignant lesions of gastric cancer A survey of European Gastroenterologists

Management of premalignant lesions of gastric cancer A survey of European Gastroenterologists. Porto, 2008/2009. Professor Doutor Altamiro da Costa Pereira. Class 16.

lynley
Download Presentation

Management of premalignant lesions of gastric cancer A survey of European Gastroenterologists

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ManagementofpremalignantlesionsofgastriccancerA surveyofEuropean Gastroenterologists Porto, 2008/2009 Professor Doutor Altamiro da Costa Pereira Class 16 Authors: Ana Silva, Andreia Carvalho, Carlos Laranja, Cláudia Leite, Daniel Oliveira, Francisco Silva, Henrique Sousa, Joana Matos, João Cardoso, Luís Vale, Mariana Santiago, Pedro Morais, Renato Ramos, Rui Loureiro, Tatiana Salazar; Supervisors: Prof. Doutor Mário Ribeiro e Dr. Ricardo Santos

  2. Management of premalignant lesions of gastric cancer INTRODUCTION RESEARCH QUESTION AIMS PARTICIPANTS AND METHODS RESULTS DISCUSSION REFERENCES

  3. Management of premalignant lesions of gastric cancer INTRODUCTION

  4. Management of premalignant lesions of gastric cancer INTRODUCTION Premalignantlesions • Atrophicchronicgastritis (ACG) • Intestinal metaplasia (IM) • Dysplasia (Dys)

  5. Management of premalignant lesions of gastric cancer RESEARCH QUESTION Which are the main options concerning diagnosis, monitoring and treatment of premalignant lesions of gastric cancer that are being taken by European Gastroenterologists?

  6. Management of premalignant lesions of gastric cancer AIMS • To assess the clinical practice in terms of diagnosis, monitoring and treatment of premalignant lesions of gastric cancer • To compile these management options into a database

  7. Managementofpremalignantlesionsofgastriccancer PARTICIPANTS AND METHODS • Typeofstudy • Observational • Cross-sectional • Quantitative

  8. Management of premalignant lesions of gastric cancer PARTICIPANTS AND METHODS Participants’ selection Non-randomizedsampling Articles search TargetPopulation: Gastroenterologists performing researchinthisfield Authors’ contactsdatabase

  9. Management of premalignant lesions of gastric cancer PARTICIPANTS AND METHODS • InclusionCriteria • EuropeanAuthor/Centre (whenindoubtwhereincluded) • Publishedbetween 2007 – 2009 • Keywords: intestinal neoplasm, precancerousconditions, adenocarcinoma, atrophicgastritis, metaplasia

  10. Managementofpremalignantlesionsofgastriccancer PARTICIPANTS AND METHODS Data collection Online Questionnaire Closed-ended questions Open-ended questions Link sent byE-mail

  11. Managementofpremalignantlesionsofgastriccancer PARTICIPANTS AND METHODS Variablesdescription • Dependent variables: • Management options taken • Independent variables: • Type of lesions • Author/Department • Place of work • Time of follow-up • How frequently techniques are applied • Diagnosis of H.P. • Eradication of H.P.

  12. Managementofpremalignantlesionsofgastriccancer Table1: E-mails response RESULTS

  13. Management of premalignant lesions of gastric cancer Graph1 RESULTS – Participantsdescription 0 - Do your answers reflect your own practice or your department(s)?

  14. Management of premalignant lesions of gastric cancer Graph 2 RESULTS – Participantsdescription

  15. Management of premalignant lesions of gastric cancer Graph 3 RESULTS Graph 4

  16. Management of premalignant lesions of gastric cancer RESULTS Graph 5 Graph 6

  17. Management of premalignant lesions of gastric cancer RESULTS Graph 7

  18. Management of premalignant lesions of gastric cancer RESULTS Graph 8

  19. Managementofpremalignantlesionsofgastriccancer RESULTS Graph 9

  20. Management of premalignant lesions of gastric cancer Graph 10 RESULTS

  21. Managementofpremalignantlesionsofgastriccancer RESULTS Graph 11

  22. Management of premalignant lesions of gastric cancer DISCUSSION Problemsandlimitations • Low response rate • wehave 12.12% of response • Notallquestionswereanswered (missing) • PossibleSelectionBias • Only sent our questionnaire to practitioners who published papers Lowsignificance/precision Hard to make generalizations - Results don’t allow for guidelines to be created

  23. Managementofpremalignantlesionsofgastriccancer DISCUSSION • Results of this study reflect some lack of consensus: • disagreement about what is the best sort of follow-up for patients with IM or ACG • techniques that should be used for the diagnosis of these lesions

  24. Managementofpremalignantlesionsofgastriccancer DISCUSSION • However, some tendencies can be identified: • diagnose H. pylori in patients with IM, ACG and Dys • eradicate the bacteria when it is diagnosed • for patients with dysplasia (both low and high grade) is to perform periodical endoscopies even if the patient is asymptomatic.

  25. Management of premalignant lesions of gastric cancer RESULTS 1. Contactsdatabase Answersto questionnaire 3. Managementoptionsdatabase 4. Online publication - Buildwebpage - Software: MS Frontpage

  26. Management of premalignant lesions of gastric cancer REFERENCES [1] Lockead P, El-Omar EM. Gastric Cancer. Br Med Bull. 2008;85:87-100. [2] Parkin DM, Bray F, Ferlay J, Pisani P..Global cancer statistics, 2002. CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108. [3] Stomach (Gastric) Cancer [Internet]. Bethesda: National Cancer Institute. Estimated new cases and deaths from stomach cancer in the United States in 2008; [cited 2008 November 1]; [1 screen]. Available from: http://www.cancer.gov/cancertopics/types/stomach 4] Plano Nacional de Prevenção e Controlo das Doenças Oncológicas 2007/2010, Dezembro 2007. [5] Sugiyama T, Asaka M. Helicobacter pylori infection and gastric cancer. Med Electron Microsc. 2004 Sep;37(3):149-57. [6] Menaker RJ, Sharaf AA, Jones NL. Helicobacter pylori infection and gastric cancer: host, bug, environment, or all three?. Curr Gastroenterol Rep. 2004 Dec;6(6):429-35. [7] de Vries AC, Haringsma J, Kuipers EJ. The detection, surveillance and treatment of premalignat gastric lesions related to Helicobacter pylori infection. Helicobacter 2007; 12: 1-15. [8] Bowles MJ, Benjamin IS. ABC of the upper gastrointestinal tract. Cancer of the stomach and pancreas. BMJ 2001;323:1413–6 [9] Witold Bartnik. Clinical aspects of Helicobacter pylori infection. Pol Arch Med Wewn, 2008; 118 (7-8): 426-430 [10] M Dinis-Ribeiro, A Costa-Pereira, C Lopes, L Moreira-Dias. Guidelines for surveillance of patients with atrophic chronic gastritis and intestinal metaplasia in stomach would be welcome! Helicobacter . 2007 Feb;12(1):1-15

  27. Management of premalignant lesions of gastric cancer ACKNOWLEDGEMENTS Eng.º Jorge Jácome Prof. Doutor Altamiro da Costa Pereira Prof. Doutor Mário Dinis Ribeiro Dr. Ricardo Santos

More Related