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 21 April 2018

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News

Treatment with self-expanding stents is safe in esophageal cancer

This month's Endoscopy finds that treatment with self-expanding metal stents is widely used in Sweden and is a reasonably safe procedure among patients with malignant dysphagia, independent of sex, age, or hospital volume.

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Endoscopic insertion of self-expanding metal stents is used for palliative treatment of esophageal and cardia cancer.

However, the safety profiles, and the influence of age, sex, and hospital volume have not previously been evaluated in a population-based setting.

Dr Wenger and colleagues from Sweden conducted a retrospective population-based study.

The investigators included all patients treated with esophageal stenting for malignant disease recorded in the Swedish national registries in the period 1997 to 2000.

The research team identified patients with esophageal or cardia cancer in the cancer registry, and those treated with esophageal stenting were selected from the in-patient registry.

Survival and emigration were assessed using the registries for causes of death and emigration, respectively.

Survival times after treatment were similar between age groups and sexes
Endoscopy

The investigative team also assessed procedure-related complications by reviewing medical records.

Stenting was conducted at 38 Swedish hospitals, with a range of 1 to 59 procedures at each hospital.

The researchers found that among 1052 registered patients with esophageal or cardia cancer, 38 % with a median age of 74 years, were treated with esophageal stenting.

After treatment, the median in-hospital stay was 7 days, and the median survival was 100 days.

The research team reported that survival times were similar between age groups and sexes.

Among 38 % of patients whom the researchers evaluated for complications, 27 % had complications of some type, while 13 % experienced direct procedure-related complications.

In addition, the investigators found no differences in complication frequencies between high-volume and low-volume centers.

The researchers noted that there were only 2 procedure-related deaths (1%), both due to esophageal perforation and no reduction in the median survival time was found in patients with complications.

Dr Wenger’s team concludes, “Treatment with self-expanding metal stents is a widely used and reasonably safe procedure among patients with malignant dysphagia, independent of sex, age, or hospital volume in Sweden.”

Endoscopy 2005: 37: 329-334
19 April 2005

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