Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy
Abstract Background Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-03-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-018-0608-6 |
| _version_ | 1819200073391669248 |
|---|---|
| author | Beomsu Shin Boksoon Chang Hojoong Kim Byeong-Ho Jeong |
| author_facet | Beomsu Shin Boksoon Chang Hojoong Kim Byeong-Ho Jeong |
| author_sort | Beomsu Shin |
| collection | DOAJ |
| description | Abstract Background Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. Methods We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea). Results The most common primary site of malignancy was esophageal cancer (37.9%), followed by thyroid cancer (16.3%) and head & neck cancer (10.2%). Bronchoscopic interventions were usually performed using a combination of mechanical debulking (84.7%), stent insertion (70.4%), and laser cauterization (37.8%). Of 98 patients, 76 (77.6%) patients had MCAO due to progression of malignancy, and 42 (42.9%) patients had exhausted all other anti-cancer treatment at the time of bronchoscopic intervention. Technical success was achieved in 89.9% of patients, and acute complications and procedure-related deaths occurred in 20.4% and 3.1% of patients, respectively. Reduced survival was associated with MCAO due to cancer other than thyroid cancer or lymphoma, mixed lesions, and not receiving adjuvant treatment after bronchoscopic intervention. Conclusions Bronchoscopic intervention could be a safe and effective procedure for MCAO due to end-stage extra-pulmonary malignancies. In addition, we identified possible prognostic factors for poor survival after intervention, which could guide clinicians select candidates that will benefit from bronchoscopic intervention. |
| first_indexed | 2024-12-23T03:26:26Z |
| format | Article |
| id | doaj.art-dbcc97b3eadb4d6aa4e0d8c10000c47f |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-23T03:26:26Z |
| publishDate | 2018-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-dbcc97b3eadb4d6aa4e0d8c10000c47f2022-12-21T18:01:50ZengBMCBMC Pulmonary Medicine1471-24662018-03-011811810.1186/s12890-018-0608-6Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancyBeomsu Shin0Boksoon Chang1Hojoong Kim2Byeong-Ho Jeong3Department of Internal Medicine, Yonsei University Wonju College of MedicineDepartment of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee UniversityDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. Methods We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea). Results The most common primary site of malignancy was esophageal cancer (37.9%), followed by thyroid cancer (16.3%) and head & neck cancer (10.2%). Bronchoscopic interventions were usually performed using a combination of mechanical debulking (84.7%), stent insertion (70.4%), and laser cauterization (37.8%). Of 98 patients, 76 (77.6%) patients had MCAO due to progression of malignancy, and 42 (42.9%) patients had exhausted all other anti-cancer treatment at the time of bronchoscopic intervention. Technical success was achieved in 89.9% of patients, and acute complications and procedure-related deaths occurred in 20.4% and 3.1% of patients, respectively. Reduced survival was associated with MCAO due to cancer other than thyroid cancer or lymphoma, mixed lesions, and not receiving adjuvant treatment after bronchoscopic intervention. Conclusions Bronchoscopic intervention could be a safe and effective procedure for MCAO due to end-stage extra-pulmonary malignancies. In addition, we identified possible prognostic factors for poor survival after intervention, which could guide clinicians select candidates that will benefit from bronchoscopic intervention.http://link.springer.com/article/10.1186/s12890-018-0608-6Interventional bronchoscopyMalignant central airway obstructionExtra-pulmonary malignancy |
| spellingShingle | Beomsu Shin Boksoon Chang Hojoong Kim Byeong-Ho Jeong Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy BMC Pulmonary Medicine Interventional bronchoscopy Malignant central airway obstruction Extra-pulmonary malignancy |
| title | Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy |
| title_full | Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy |
| title_fullStr | Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy |
| title_full_unstemmed | Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy |
| title_short | Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy |
| title_sort | interventional bronchoscopy in malignant central airway obstruction by extra pulmonary malignancy |
| topic | Interventional bronchoscopy Malignant central airway obstruction Extra-pulmonary malignancy |
| url | http://link.springer.com/article/10.1186/s12890-018-0608-6 |
| work_keys_str_mv | AT beomsushin interventionalbronchoscopyinmalignantcentralairwayobstructionbyextrapulmonarymalignancy AT boksoonchang interventionalbronchoscopyinmalignantcentralairwayobstructionbyextrapulmonarymalignancy AT hojoongkim interventionalbronchoscopyinmalignantcentralairwayobstructionbyextrapulmonarymalignancy AT byeonghojeong interventionalbronchoscopyinmalignantcentralairwayobstructionbyextrapulmonarymalignancy |