Transcript Management of premalignant lesions of gastric cancer

Management of premalignant lesions of
gastric cancer: a survey of the main options
applied in European Gastroenterology
centres
Research Protocol
Class 16
Porto, 2008/2009
Authors: Ana Silva, Andreia Carvalho, Carlos Laranja, Cláudia Leite, Daniel Oliveira, Francisco Silva, Henrique Sousa, Joana
Matos, João Cardoso, Luís Vale, Mariana Santiago, Pedro Morais, Renato Ramos, Rui Loureiro, Tatiana Salazar;
Supervisors: Dr. Mário Ribeiro e Dr. Ricardo Santos
Introduction
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
Introduction
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
Yamaoka Y, Kato M, Asaka M. Geographic differences in gastric cancer incidence can be explained by differences between
Helicobacter pylori strains. Internal Medicine. 2008; 47: 1077-1083.
Introduction
Premalignant lesions of gastric cancer:
Introduction
Research question
Aims
Participants and
Methods
High mortality and morbidity
Absence of consensus in terms of diagnosis and
treatment
Lack of guidelines
Expected results
References
Yamaoka Y, Kato M, Asaka M. Geographic differences in gastric cancer incidence can be explained by differences between
Helicobacter pylori strains. Internal Medicine. 2008; 47: 1077-1083.
Research question
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
Which are the main options
for diagnosis and treatment of
premalignant
lesions
of
gastric cancer that are being
taken at an European level?
Aims
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
• Identify options in terms of diagnosis
of the premalignant lesions of gastric
cancer that are being taken at an
European level
• Identify options in terms of treatment
of the premalignant lesions of gastric
cancer that are being taken at an
European level
• Compile these management options
in a database
Study Design
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
• Type of study: observational
and cross-sectional
• Participants’ selection
• Data collection
• Statistical analysis of data
• Discussion about expected
results
Study Participants
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
• Target population:
- all European Gastroenterology centres
• Sample:
- Selection of the centres included by two
ways:
1st: list of the Gastroenterology societies of different
countries from ESG site;
2nd: centres involved in the publication of papers on
this subject
non-randomized sample
Data Collection Methods
Introduction
Questionnaire
Research question
Aims
Participants and
Methods
Expected results
References
Open ended
questions
Closed ended
questions
Sent by e-mail
Backup plan: phone
interview
Online Database
Variables Description / Planned
Statistical Analysis
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
• Dependent variables:
– Management options taken
– Follow-up of patients
• Independent variables:
– Type of lesions
– Centre
– Geographical location
– etc
hypothesis test
Expected Results
Introduction
Phases:
1. Contacts’ database
Research question
Aims
Participants and
Methods
Expected results
References
considerable number of centres’
Creation of guidelines
contacts
2. Questionnaire’ s answers
European Practice Protocol
low response rate
3. Management options’ database
the most frequently used options
Expected Results
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
Problems and limitations:
• low response rate from the countries’
societies;
• refusal from some centres to take part in our
study;
• refusal from some centres to answer some
questions;
• selection bias – societies may give us only the
contacts of the centres with positive results in
the management of those lesions or from
those that are in the forefront of the
techniques used in their diagnosis and
treatment;
• possibility of obtaining data referring to only
one country, or data from very few countries to
take conclusions at an European level.
References
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Introduction
•
Research question
Aims
•
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Participants and
Methods
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Expected results
•
References
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[1] Lockead P, El-Omar EM. Gastric Cancer. Br Med Bull. 2008;85:87-100.
[2] Parkin DM, Bray F, Ferlay J, Pisani P..Global cancer statistics, 2002. CA
Cancer J Clin. 2005 Mar-Apr;55(2):74-108.
[3] Stomach (Gastric) Cancer [Internet]. Bethesda: National Cancer Institute.
Estimated new cases and deaths from stomach cancer in the United States in
2008; [cited 2008 November 1]; [1 screen]. Available from:
http://www.cancer.gov/cancertopics/types/stomach
4] Plano Nacional de Prevenção e Controlo das Doenças Oncológicas
2007/2010, Dezembro 2007.
[5] Sugiyama T, Asaka M. Helicobacter pylori infection and gastric cancer. Med
Electron Microsc. 2004 Sep;37(3):149-57.
[6] Menaker RJ, Sharaf AA, Jones NL. Helicobacter pylori infection and gastric
cancer: host, bug, environment, or all three?. Curr Gastroenterol Rep. 2004
Dec;6(6):429-35.
[7] de Vries AC, Haringsma J, Kuipers EJ. The detection, surveillance and
treatment of premalignat gastric lesions related to Helicobacter pylori infection.
Helicobacter 2007; 12: 1-15.
[8] Bowles MJ, Benjamin IS. ABC of the upper gastrointestinal tract. Cancer of
the stomach and pancreas. BMJ 2001;323:1413–6
[9] Witold Bartnik. Clinical aspects of Helicobacter pylori infection. Pol Arch Med
Wewn, 2008; 118 (7-8): 426-430
[10] M Dinis-Ribeiro, A Costa-Pereira, C Lopes, L Moreira-Dias. Guidelines for
surveillance of patients with atrophic chronic gastritis and intestinal metaplasia
in stomach would be welcome! Helicobacter . 2007 Feb;12(1):1-15