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Research Protocol

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.

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Research Protocol

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  1. 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

  2. Introduction Introduction Research question Aims Participants and Methods Expected results References

  3. Introduction Research question Aims Participants and Methods Expected results References Introduction 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.

  4. Introduction Research question Aims Participants and Methods Expected results References Introduction Premalignant lesions of gastric cancer: High mortality and morbidity Absence of consensus in terms of diagnosis and treatment 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.

  5. Introduction Research question Aims Participants and Methods Expected results References Research question Which are the main options for diagnosis and treatment of premalignant lesions of gastric cancer that are being taken at an European level?

  6. Aims • 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 Introduction Research question Aims Participants and Methods Expected results References

  7. Introduction Research question Aims Participants and Methods Expected results References Study Design • Type of study: observational and cross-sectional • Participants’ selection • Data collection • Statistical analysis of data • Discussion about expected results

  8. Study Participants • Targetpopulation: • - allEuropeanGastroenterology centres • Sample: • - Selectionofthe centres includedbytwoways: • 1st: listoftheGastroenterologysocietiesofdifferentcountriesfrom ESG site; • 2nd: centres involvedinthepublicationofpapersonthissubject • non-randomizedsample Introduction Research question Aims Participants and Methods Expected results References

  9. Data Collection Methods Introduction Questionnaire Research question Aims Open ended questions Closed ended questions Participants and Methods Sent by e-mail Expected results Backup plan: phone interview References Online Database

  10. Variables Description / Planned Statistical Analysis • Dependent variables: • Management options taken • Follow-up of patients • Independent variables: • Type of lesions • Centre • Geographical location • etc • hypothesis test Introduction Research question Aims Participants and Methods Expected results References

  11. Introduction Research question Aims Participants and Methods Expected results References Expected Results Phases: 1. Contacts’ database considerable number of centres’ contacts 2. Questionnaire’ s answers low response rate 3. Management options’ database the most frequently used options Creation of guidelines European Practice Protocol

  12. Expected Results • 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. Introduction Research question Aims Participants and Methods Expected results References

  13. Introduction Research question Aims Participants and Methods Expected results References References • [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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