Patient-reported outcomes in palliative gastrointestinal stenting: a Norwegian multicenter study

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Oncology

Background:

• Physician-reported outcomes have dominated stent treatment evaluations.
• Limited prospective studies utilize patient-reported outcomes (PROs) for stent efficacy.
• Assessing malignant gastrointestinal (GI) and biliary obstructions requires patient perspectives.

Purpose of the Study:

• To evaluate the clinical effect of self-expanding metal stents (SEMS) in malignant GI obstructions using PROs.
• To compare patient and physician ratings of SEMS treatment effectiveness.
• To investigate the impact of SEMS on obstruction-related symptoms and global health.

Main Methods:

• A prospective study involving 273 patients treated with SEMS for malignant GI/biliary obstructions.
• Patients and physicians independently assessed symptoms pre-treatment and at 2-week follow-up.
• The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and obstruction-specific questions were used.

Main Results:

• 162 patients completed the study; significant global health score improvement observed post-SEMS (P < 0.03).
• Both patients and physicians reported significant reduction in obstruction symptoms (P < 0.006).
• Physicians reported greater symptom improvement than patients, potentially due to baseline severity differences.

Conclusions:

• SEMS treatment effectively alleviates symptoms of malignant GI and biliary obstruction, confirmed by both patient and physician reports.
• Discrepancies in reported symptom reduction highlight the importance of patient perspectives.
• Prospective assessment of PROs is crucial for comprehensive SEMS treatment evaluation.