A251 TC-325 USE IN MALIGNANT UPPER GASTROINTESTINAL BLEEDS: A MULTICENTRE RETROSPECTIVE STUDY
Bibliographic record
Abstract
TC-325 has recently been proposed as a potential therapeutic agent for use in traditionally difficult to treat malignant upper gastrointestinal bleeds (UGIB). The aim of this study is to assess the proportion of patients with malignant UGIB treated with either TC-325 alone or in combination with conventional therapy that achieve long-term hemostasis. This is a multicentre retrospective study at the University of Calgary and University of Ottawa assessing the efficacy of TC-325 in achieving hemostasis in malignant UGIB between January 1, 2010 and July 30, 2016. TC-325 use was identified via staff polling, product order forms, and endoscopic records review. Once identified, patient charts and online records (Sunrise Clinical Manager, Calgary; vOACIS, Ottawa) were reviewed to identify those with malignant UGIB and to assess our primary and secondary endpoints. The primary outcome was hemostasis at 7 days. Secondary outcomes include immediate hemostasis, the need for repeat endoscopy, surgical intervention, transarterial embolization, and 30-day mortality. TC-325 was utilized for malignant UGIB in 19 patients. The median age was 68 (IQR 57–78), 11 were males (58%). Fifteen patients (79%) were Forrest Classification 1B with a median Blatchford score of 11 (IQR 7–12). TC-325 was utilized as the primary modality for hemostasis in 15 patients (79%). Eighteen patients (95%) achieved immediate hemostasis post-TC-325 and 8 patients (42%) eventually rebled after this. Three patients (16%) had recurrent bleeding within 24 hours. Only 13 patients had sufficient data to examine our primary endpoint of 7 days and 4 (31%) rebled by that time (all in Calgary). Three patients died before 7 days and 3 changed their goals of care. At 14 days, 3 patients (25%) rebled. A repeat endoscopy was required in 7 patients (37%). Two patients (11%) required surgical intervention. Transarterial embolization was not required. Ten patients died by 30 days (53%); one due to perforation of their malignant ulcer and another from an uncontrollable malignant UGIB. There were no complications directly associated with TC-325. This is the first multicenter study evaluating 7-day hemostasis when TC-325 is used in malignant UGIB. TC-325 is effective at immediate and early hemostasis. However, rebleeding risk is increased by day 7 post-treatment. TC-325 may be utilized to immediately achieve hemostasis. Up to a third of patients may require another definitive intervention to achieve long-term hemostasis. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".