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...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-09-01
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| Series: | Therapeutic Advances in Gastrointestinal Endoscopy |
| Online Access: | https://doi.org/10.1177/26317745231200975 |
| _version_ | 1797673300340506624 |
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| author | José Miguel Jiménez-Gutiérrez Juan Octavio Alonso-Lárraga Angélica I. Hernández-Guerrero Leonardo Saul Lino-Silva Antonio Olivas-Martinez |
| author_facet | José Miguel Jiménez-Gutiérrez Juan Octavio Alonso-Lárraga Angélica I. Hernández-Guerrero Leonardo Saul Lino-Silva Antonio Olivas-Martinez |
| author_sort | José Miguel Jiménez-Gutiérrez |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T21:42:33Z |
| format | Article |
| id | doaj.art-4085d0bc63da42f79da62ac04405c785 |
| institution | Directory Open Access Journal |
| issn | 2631-7745 |
| language | English |
| last_indexed | 2024-03-11T21:42:33Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastrointestinal Endoscopy |
| spelling | doaj.art-4085d0bc63da42f79da62ac04405c7852023-09-26T12:33:22ZengSAGE PublishingTherapeutic Advances in Gastrointestinal Endoscopy2631-77452023-09-011610.1177/26317745231200975Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life studyJosé Miguel Jiménez-GutiérrezJuan Octavio Alonso-LárragaAngélica I. Hernández-GuerreroLeonardo Saul Lino-SilvaAntonio Olivas-MartinezBackground: 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.https://doi.org/10.1177/26317745231200975 |
| spellingShingle | José Miguel Jiménez-Gutiérrez Juan Octavio Alonso-Lárraga Angélica I. Hernández-Guerrero Leonardo Saul Lino-Silva Antonio Olivas-Martinez Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study Therapeutic Advances in Gastrointestinal Endoscopy |
| title | Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study |
| title_full | Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study |
| title_fullStr | Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study |
| title_full_unstemmed | Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study |
| title_short | Efficacy and safety of self-expanding metal stents in patients with inoperable esophageal cancer: a real-life study |
| title_sort | efficacy and safety of self expanding metal stents in patients with inoperable esophageal cancer a real life study |
| url | https://doi.org/10.1177/26317745231200975 |
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