Methods of stent placement in patients with upper-third and middle-third esophageal cancer

S. I. Kirkilevsky, P. S. Krahmalyov, R. I. Frydel, O. Y. Dobrzhanskyi

DOI: http://dx.doi.org/10.12775/JEHS.2019.09.11.006

Abstract


Relevance. At that moment of diagnosis patients with esophageal cancer (EC) are often inoperable due to locally advanced disease. Life expectancy in such cases augmented with dysphagia comprises 90 days in average. Curative treatment can be performed only in 20-30 % of patients with a 5-year survival rate varying from 10,3 to 35%.

Objective. Assessing short-term and long-term outcomes of patients with stents with EC depending on the localization of the primary tumor.

Materials and methods. We analyzed our experience of using intraesophageal self-expanding stents in ЕС patients. 49 of patients them had tumor in upper-third of esophagus and 73 patients had middle-third esophageal tumor location as compared to those who underwent stoma formation (53 patients) in EC patients.

Results. All patients who were stented had significantly lower grade of dysphagia and could eat in the ordinary way. It also improved quality of life, and many of such patients had an opportunity to continue treatment. It has been revealed that stenting of inoperable cancer patients with upper and middle-third esophageal cancer gives benefit to patients as it allows to continue to eat naturally and thereby significantly improves the quality of life in contrast to stoma placement. Patients with upper-third esophageal cancer who were not stented because of fistula formation had significantly better long-term survival than EC patients with stoma and similar cancer patients with middle-third esophageal tumors. Survival rate of patients with cancer of upper-third of esophagus after stenting not because of fistula was significantly better. Patients with cancer of the middle esophagus, who experienced stent placement because of fistulae, had the same long-term survival rate as cancer patients with middle esophageal tumors  and with fistula who were not stented. It shows high efficacy of stenting in cancer of the middle-third esophagus with presence of fistula.

Conclusion. Stent placement in case of inoperable cancer of upper and middle-third of esophagus shows significant benefit. It allows patients to eat in an ordinary was, and thereby significantly improves the quality of life in comparison with stoma formation.


Keywords


Esophageal cancer; stent; stent placement

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References


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