Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study.

Background: Dysphagia is the most frequent symptom in patients diagnosed with esophageal cancer. Self-expanding metal stents (SEMS) are the current palliative treatment of choice for dysphagia in patients with non-curable esophageal cancer. This study aimed to evaluate the efficacy and adverse event...

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Publicado en:Therapeutic Advances in Gastrointestinal Endoscopy pp. 1 - 11
Autores principales: Jiménez-Gutiérrez, José Miguel, Alonso-Lárraga, Juan Octavio, Hernández-Guerrero, Angélica I., Lino-Silva, Leonardo Saul, Olivas-Martinez, Antonio
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 9/26/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/26/2023
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study.
      aug:
        au:
          Jiménez-Gutiérrez, José Miguel
          Alonso-Lárraga, Juan Octavio
          Hernández-Guerrero, Angélica I.
          Lino-Silva, Leonardo Saul
          Olivas-Martinez, Antonio
        affil: Conceptualization, Department of Endoscopy, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, Ciudad de México 14080, México
      sug:
        subj:
          Esophageal Neoplasms Complications
          Stents Evaluation
          Equipment Safety Evaluation
          Stents Adverse Effects
          Deglutition Disorders Surgery
          Treatment Outcomes
          Human
          Retrospective Design
          Prospective Studies
          Tertiary Health Care
          Descriptive Statistics
          Male
          Female
          Pretest-Posttest Design
          Data Analysis Software
          Cox Proportional Hazards Model
          Middle Age
          Aged
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Dysphagia is the most frequent symptom in patients diagnosed with esophageal cancer. Self-expanding metal stents (SEMS) are the current palliative treatment of choice for dysphagia in patients with non-curable esophageal cancer. This study aimed to evaluate the efficacy and adverse events (AEs) of different types of SEMS for palliation of dysphagia. Methods: We performed a retrospective cohort study of patients with advanced esophageal cancer and SEMS placement for dysphagia palliation in a tertiary care center. The primary outcome was the clinical success defined as an improvement in dysphagia (reduction of at least 2 points in the Mellow–Pinkas scoring system for dysphagia) after SEMS placement. Results: Between January 1999 and May 2020, 295 patients with esophageal cancer were identified. Among them, 75 had a SEMS placement for dysphagia palliation. The mean age of the patients was 61.3 years (standard deviation: 13.4), 69 patients (92%) were men, and the mean Mellow–Pinkas scoring for dysphagia pre- and post-SEMS placement were 3.1 and 1.4 (change from baseline −1.7), respectively. Technical success and clinical success were achieved in 98.6% and 58.9%, respectively. AEs were identified in 35/75 patients (46.7%), and SEMS migration was the most frequent AE in 22/75 patients (29.3%). There were no significant differences in improvement in dysphagia (p = 0.054), weight changes (p = 0.78), and AE (p = 0.73) among fully covered SEMS (fc-SEMS) and partially covered SEMS (pc-SEMS). The median follow-up was 89 days (interquartile range: 29–221). Conclusion: SEMS placement was associated with a rapid improvement in dysphagia, high technical success, and a modest improvement in dysphagia with no major AE among fc-SEMS and pc-SEMS.
      pubtype: Academic Journal
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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