Effectiveness and safety of chemotherapy for patients with malignant gastrointestinal obstruction: A Japanese population-based cohort study

doi:10.12998/wjcc.v10.i16.5253

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World Journal of Clinical Cases

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World J Clin Cases. Jun 6, 2022; 10(16): 5253-5265
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5253

Effectiveness and safety of chemotherapy for patients with malignant gastrointestinal obstruction: A Japanese population-based cohort study

Gota Fujisawa, Ryota Niikura, Takuya Kawahara, Tetsuro Honda, Kenkei Hasatani, Naohiro Yoshida, Tsutomu Nishida, Tetsuya Sumiyoshi, Shu Kiyotoki, Takashi Ikeya, Masahiro Arai, Yoku Hayakawa, Takashi Kawai, Mitsuhiro Fujishiro

Gota Fujisawa, Yoku Hayakawa, Mitsuhiro Fujishiro, Department of Gastroenterology, Graduate school of Medicine, The University of Tokyo, Tokyo 1138655, Japan

Ryota Niikura, Takashi Kawai, Gastroenterological Endoscopy, Tokyo Medical University, Tokyo 1600023, Japan

Takuya Kawahara, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo 1138655, Japan

Tetsuro Honda, Department of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki 8508555, Japan

Kenkei Hasatani, Department of Gastroenterology, Fukui Prefectural Hospital, Fukui 9108526, Japan

Naohiro Yoshida, Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa 9208530, Japan

Tsutomu Nishida, Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka 5608565, Japan

Tetsuya Sumiyoshi, Department of Gastroenterology, Tonan Hospital, Hokkaido 0600004, Japan

Shu Kiyotoki, Department of Gastroenterology, Shuto General Hospital, Yamaguchi 7420032, Japan

Takashi Ikeya, Department of Gastroenterology, St. Luke's International Hospital, Tokyo 1048560, Japan

Masahiro Arai, Department of Gastroenterology, Nerima Hikarigaoka Hospital, Tokyo 1790072, Japan

Author contributions: All authors contributed to the acquisition of data for this study; Fujisawa G analyzed the data and wrote the draft manuscript; Niikura R designed the research study; Kawahara T contributed data analysis; Honda T, Hasatani K, Yoshida N, Nishida T, Sumiyoshi T, Kiyotoki S, Ikeya T, Arai M, Hayakawa Y, Kawai T, and Fujishiro M performed the research; All authors have read and approved the final manuscript.

Supported by the Tokyo Medical University Cancer Research Foundation, No. 2021; and KAKENHI Grants-in-Aid for Scientific Research, No. 20K08375.

Institutional review board statement: This study was approved by the Institutional Review Board of the University of Tokyo Hospital (No. 2019161NI) and conducted ethically in accordance with the World Medical Association Declaration of Helsinki.

Informed consent statement: Informed consent was obtained in the form of opt-out on the website.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Data sharing statement: No additional data are available.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Ryota Niikura, MD, PhD, Adjunct Associate Professor, Doctor, Gastroenterological Endoscopy, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 1600023, Japan. rniikura@triton.ocn.ne.jp

Received: December 30, 2021
Peer-review started: December 30, 2021
First decision: March 7, 2022
Revised: March 9, 2022
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 6, 2022

Core Tip

Core Tip: The impacts of chemotherapy on patients with malignant gastrointestinal obstructions remain unclear, and multicenter evidence is lacking. Does chemotherapy improve the duration of gastrointestinal patency (and thus overall survival) in such patients? This multicenter observational study revealed that the median patency duration in the chemotherapy group was longer than that in the best supportive care group (9.7 vs 2.5 mo). Similarly, the median overall survival was longer in the chemotherapy than the best supportive care group (19.3 vs 5.4 mo, log-rank test, P < 0.01).