Management of Bleeding from Unresectable Gastric Cancer

Bleeding from unresectable gastric cancer (URGC) is not a rare complication. Two major ways in which the management of this issue differs from the management of benign lesions are the high rate of rebleeding after successful hemostasis and that not only endoscopic therapy (ET) and transcatheter arte...

Full description

Saved in:
Bibliographic Details
Published in:Biomedicines 2019-07, Vol.7 (3), p.54
Main Authors: Kawabata, Hideaki, Hitomi, Misuzu, Motoi, Shigehiro
Format: Article
Language:English
Subjects:
Bleeding
Cancer therapies
Classification
Embolization
Endoscopy
Gastric cancer
Hemorrhage
Hemostasis
Medical prognosis
Mortality
palliative radiotherapy
Patients
Quality of life
Radiation therapy
Review
transcatheter arterial embolization
Ulcers
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Bleeding from unresectable gastric cancer (URGC) is not a rare complication. Two major ways in which the management of this issue differs from the management of benign lesions are the high rate of rebleeding after successful hemostasis and that not only endoscopic therapy (ET) and transcatheter arterial embolization (TAE) but palliative radiotherapy (PRT) can be applied in the clinical setting. However, there are no specific guidelines concerning the management of URGC with bleeding. We herein discuss strategies for managing bleeding from URGC. A high rate of initial hemostasis for active bleeding is expected when using various ET modalities properly. If ET fails in patients with hemostatic instability, emergent TAE is considered in order to avoid a life-threating condition due to massive bleeding. Early PRT, especially, regimens with a high biologically effective dose (BED) of ≥39 Gy should be considered not only for patients with hemostatic failure but also for those with successful hemostasis and inactive hemorrhage, as longer duration of response with few complications can be expected. Further prospective, comparative studies considering not only the hemostatic efficacy of these modalities but the patients' quality of life are needed in order to establish treatment strategies for bleeding from URGC.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines7030054