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NESS 2006 Annual Meeting
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Palliative Procedures in Patients With Stage IV GI Tract Cancer
Nathan Aranson1, Giles F Whalen2
1UMass Medical School, Worcester, MA;2UMass-Memorial Health System, Worcester, MA

Objective: To determine the number, type and efficacy of invasive procedures performed to palliate symptoms caused by stage IV GI tract malignancies.
Design: Retrospective review
Setting: Academic Medical Center
Patients: 298 Patients identified by the tumor registry as being diagnosed with stage IV malignant tumors of the GI tract between 2000-2005.
Interventions: Chart review to confirm study inclusion criteria and determine which of these patients received invasive procedures (surgical, urologic, radiologic and endoscopic) to relieve symptoms caused by their tumor
Main outcome measure: number and type of procedures
Results: 249 of these patients had expired prior to the review. 306 procedures were performed in 193 patients (avg 1.06 procedures/patient). 270 procedures had palliation as an overtly stated aim of the procedure and these relieved the symptom 90% of the time (244 procedures). There were 146 surgical procedures performed with palliative intent and these were similarly effective. The most common symptoms treated were bowel obstruction (24%), bleeding (21%), obstructive jaundice (11%), and pain associated with ascites (9%). Procedural morbidity was 24% and mortality 5%. 126 patients (44%) received palliative chemotherapy and 50 patients (20%) received palliative radiation.
Conclusions: Palliative procedures are performed commonly in this patient population and appear to provide effective symptom relief.

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