Chidambaram, Swathikan, Patel, Nikhil M., Sounderajah, Viknesh, Alfieri, Rita ORCID: 0000-0002-4993-2197, Bonavina, Luigi ORCID: 0000-0002-4880-1670, Cheong, Edward, Cockbain, Andy, D'Journo, Xavier Benoit, Ferri, Lorenzo, Griffiths, Ewen A., Grimminger, Peter, Gronnier, Caroline, Gutschow, Christian, Hedberg, Jakob, Kauppila, Joonas H., Lagarde, Sjoerd, Low, Donald, Nafteux, Philippe, Nieuwenhuijzen, Grard, Nilsson, Magnus, Rosati, Riccardo, Schroeder, Wolfgang, Smithers, B. Mark, Henegouwen, Mark I. van Berge, van Hillegesberg, Richard, Watson, David, I, Vohra, Ravinder, Maynard, Nick and Markar, Sheraz R. (2022). Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer: a modified Delphi consensus process. Dis. Esophagus, 36 (1). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

Background: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. Methods: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. Results: 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. Conclusion: There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Chidambaram, SwathikanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Patel, Nikhil M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sounderajah, VikneshUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alfieri, RitaUNSPECIFIEDorcid.org/0000-0002-4993-2197UNSPECIFIED
Bonavina, LuigiUNSPECIFIEDorcid.org/0000-0002-4880-1670UNSPECIFIED
Cheong, EdwardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cockbain, AndyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
D'Journo, Xavier BenoitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferri, LorenzoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Griffiths, Ewen A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grimminger, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gronnier, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutschow, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hedberg, JakobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kauppila, Joonas H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lagarde, SjoerdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Low, DonaldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nafteux, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nieuwenhuijzen, GrardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nilsson, MagnusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosati, RiccardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schroeder, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smithers, B. MarkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henegouwen, Mark I. van BergeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Hillegesberg, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Watson, David, IUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vohra, RavinderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maynard, NickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Markar, Sheraz R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698416
DOI: 10.1093/dote/doac038
Journal or Publication Title: Dis. Esophagus
Volume: 36
Number: 1
Date: 2022
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1442-2050
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ESOPHAGECTOMY; ADENOCARCINOMAMultiple languages
Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69841

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