Endoscopy for the diagnosis and treatment of gastrointestinal bleeding caused by malignancy

Hamzah Abu-Sbeih, David Szafron, Ahmed A. Elkafrawy, Victor Garcia-Rodriguez, Weijie Ma, Ann Xu, Shruti Khurana, Laith Numan, Ellie Chen, Ryan Goldstein, Adrianne Tsen, Yuanzun Peng, Mariela Blum, Edmund S. Kopetz, Naruhiko Ikoma, Malek Shatila, Wei Qiao, Gottumukkala S. Raju, William A. Ross, Phillip S. GeEmmanuel Coronel, Yinghong Wang

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background and Aim: The diagnosis and treatment of gastrointestinal (GI) bleeding secondary to malignancy can be challenging. Endoscopy is the gold standard to diagnose and treat gastrointestinal bleeding but clinical characteristics and outcomes of patients with malignancy-related bleeding are not well understood. This study aims to look at clinical characteristics, endoscopic findings, safety and clinical outcomes of endoscopic interventions for GI malignancy-related bleeding. Methods: We retrospectively reviewed outcomes of patients with confirmed GI malignancies who underwent endoscopy for GI bleeding at MD Anderson Cancer Center between 2010 and 2019. Cox hazard analysis was conducted to identify factors associated with survival. Results: A total of 313 patients were included, with median age of 59 years; 74.8% were male. The stomach (30.0%) was the most common tumor location. Active bleeding was evident endoscopically in 47.3% of patients. Most patients (77.3%) did not receive endoscopic treatment. Of the patients who received endoscopic treatment, 57.7% had hemostasis. No endoscopy-related adverse events were recorded. Endoscopic treatment was associated with hemostasis (P < 0.001), but not decreased recurrent bleeding or mortality. Absence of active bleeding on endoscopy, stable hemodynamic status at presentation, lower cancer stage, and surgical intervention were associated with improved survival. Conclusions: This study indicates that endoscopy is a safe diagnostic tool in this patient population; while endoscopic treatments may help achieve hemostasis, it may not decrease the risk of recurrent bleeding or improve survival.

Original languageEnglish (US)
Pages (from-to)1983-1990
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume37
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • cancer bleeding
  • endoscopic hemostasis
  • gastrointestinal bleeding
  • GI tumor bleeding
  • malignancy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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