Authors' objectives:

This bulletin aims to summarise the available evidence on the management of upper gastro-intestinal cancers.

Authors' recommendations: Most people with cancer of the upper gastro-intestinal system survive for only a few months after diagnosis. Long-term (five-year) survival rates for England and Wales for oesophageal, stomach and pancreatic cancer are 9%, 12%, and 3% respectively. These survival rates are generally worse than those reported by other developed countries. This is particularly apparent in stomach cancer, for which the European average five-year survival rate is 21%. Surgery is difficult and hazardous. One English region has reported that 15% of patients with oesophageal cancer and 18% with pancreatic cancer die within a month of surgery. Equivalent figures from specialist centres are below 5%. Clinicians and hospitals treating larger numbers of patients with these cancers achieve better outcomes. interventions for the management of upper gastro-intestinal cancers Chemotherapy can have some impact on survival and may help with symptom control. Radiotherapy is only appropriate for a small minority of patients with oesophageal cancer. Most patients require palliative interventions, in particular stent insertion to permit swallowing or treat jaundice. Pain control is crucial, especially in pancreatic cancer. Surgical interventions such as destruction of the local nerve plexus are often effective.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination