Transcript 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: Silva AJ, Carvalho A, Laranja C A, Leite C, Oliveira D, Silva F, Sousa H, Matos J, Cardoso J, Vale L, Santiago M,
Morais P, Ramos R, Loureiro R, Salazar T.;
Supervisors: Dinis-Ribeiro M, Santos R.
Introduction
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
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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.
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Introduction
Introduction
Premalignant lesions of gastric
cancer:
Research question
Aims
Participants and
Methods
Expected results
High mortality and morbidity
Absence of consensus in terms of
diagnosis and treatment
References
Lack of guidelines
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.
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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?
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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
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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
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Study Participants
Introduction
• Target population:
- all European Gastroenterology centres
Research question
Aims
Participants and
Methods
Expected results
References
• 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
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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
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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
– Kind of Centre
– Geographical location
hypothesis test
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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
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Expected Results
Problems and limitations
Introduction
Research question
Aims
Participants and
Methods
Expected results
References
• 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.
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References
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Introduction
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Research question
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Aims
Participants and
Methods
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
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