Self-expanding metallic stents are a first-line therapeutic procedure in the palliative treatment of dysphagia in patients with esophageal cancer.
However, the impact of self-expanding metallic stents insertion on patient nutritional status has never been assessed.
Dr Stéphane Lecleire and colleagues from France evaluated the nutritional status of patients after insertion of a self-expanding metallic stents.
The team also assessed the impact of a preexisting undernutrition status on survival.
|Dysphagia scores decreased after stent insertion in 89%|
The researchers conducted a retrospective observational study of a total of 120 patients treated in a single center by insertion of a self-expanding metallic stents.
The patients received self-expanding metallic stents for relief of dysphagia in the palliative treatment of esophageal cancer.
Efficacy of self-expanding metallic stents was assessed by the Ogilvie's dysphagia score.
Patient nutritional and clinical statuses were evaluated at self-expanding metallic stents insertion, and patients were regularly followed until death.
The researchers investigated independent predictive factors of early 30-day mortality.
The team found that dysphagia scores decreased after self-expanding metallic stents insertion in 89% of patients, with median scores decreasing from 3 to 1.
There was a significant decrease in body mass index, serum albumin level, and World Health Organization performance index at a 1-month evaluation.
The team noted that serum albumin level, and body mass index less than 18 kg/m2 were independent predictors of 30-day mortality.
A World Health Organization performance index more than 2 at stent insertion was an independent predictive factors of 30-day mortality.
Dr Lecleire's team concludes, “This study suggested that palliative stent placement in esophageal cancer was effective to relieve dysphagia but was not followed by an improvement of nutritional parameters.”
“Moreover, it underlined the key role played by undernutrition on survival.”