Bruno Costa Martins, Julia Mayumi Gregorio, Rafael Utimura Sueta, Déborah Marques Centeno, Pastor Joaquín Ortiz Mendieta, Marcelo Simas de Lima, Renata Nobre Moura, Luciano Lenz, Caterina Maria Pia Simioni Pennacchi, Andressa Abnader Machado, Rubens Antonio Aissar Sallum, Fauze Maluf-Filho
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Technical and clinical success rates, improvement in dysphagia and adverse events were analyzed. A total of 364 patients were included (291 men, mean age 60.8 years). The technical success was 100%, with 88% of patients showing improvement in dysphagia after stent placement. Adverse events occurred in 58% of cases, with stent-induced fistula (14%) and stent migration (9%) being the most common. There was no relationship between stent covering (partially versus fully covered) and adverse events (fistula P = 0.056; migration P = 0.264; in/overgrowth P = 0.825). Median overall survival was 207.2 days, with 1-month and 3-month survival rates of 82% and 66%, respectively. Placement of esophageal SEMS in patients with advanced esophageal tumors has high technical and clinical success rates. It immediately improves dysphagia in most patients. Stent-induced fistula and stent migration are the most common adverse events. Their occurrence is not influenced by previous chemo radiation or the type of stent covering. 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引用次数: 0
摘要
食管癌通常在晚期诊断,导致严重的吞咽困难,影响患者的生活质量。本研究旨在评价自膨胀金属支架(SEMS)在晚期食管癌姑息治疗中的疗效和安全性。这项观察性研究在一家三级癌症中心进行,分析了一个前瞻性维护的数据库,其中分析了2009年1月至2021年1月期间接受SEMS安置的患者。分析了技术和临床成功率、吞咽困难的改善情况和不良事件。共纳入364例患者(男性291例,平均年龄60.8岁)。技术成功率为100%,88%的患者在支架置入后出现吞咽困难的改善。58%的病例发生了不良事件,支架诱发瘘(14%)和支架迁移(9%)是最常见的。支架覆盖(部分覆盖与完全覆盖)与不良事件(瘘P = 0.056;迁移P = 0.264;in/overgrowth P = 0.825)。中位总生存期为207.2天,1个月和3个月生存率分别为82%和66%。在晚期食管肿瘤患者中放置食管SEMS具有很高的技术和临床成功率。它能立即改善大多数患者的吞咽困难。支架诱发瘘和支架移位是最常见的不良事件。其发生不受既往化疗放疗或支架覆盖类型的影响。在大多数情况下,它们可以通过内窥镜治疗。
Efficacy and safety of self-expanding metal stents in advanced esophageal cancer: a 12-year analysis in a referral center.
Esophageal cancer is often diagnosed in advanced stages, leading to significant dysphagia and affecting patients' quality of life. This study aims to evaluate the efficacy and safety of self-expanding metallic stents (SEMS) for the palliative treatment of advanced esophageal cancer. This observational study was conducted in a tertiary cancer center, analyzing a prospectively maintained database where those undergoing SEMS placement between January 2009 and January 2021 were analyzed. Technical and clinical success rates, improvement in dysphagia and adverse events were analyzed. A total of 364 patients were included (291 men, mean age 60.8 years). The technical success was 100%, with 88% of patients showing improvement in dysphagia after stent placement. Adverse events occurred in 58% of cases, with stent-induced fistula (14%) and stent migration (9%) being the most common. There was no relationship between stent covering (partially versus fully covered) and adverse events (fistula P = 0.056; migration P = 0.264; in/overgrowth P = 0.825). Median overall survival was 207.2 days, with 1-month and 3-month survival rates of 82% and 66%, respectively. Placement of esophageal SEMS in patients with advanced esophageal tumors has high technical and clinical success rates. It immediately improves dysphagia in most patients. Stent-induced fistula and stent migration are the most common adverse events. Their occurrence is not influenced by previous chemo radiation or the type of stent covering. In most cases, they can be endoscopically managed.