Self-expandable metal stents are a valid option in long-term survivors of advanced esophageal cancer

• Eduardo Rodrigues-Pinto ^[1] ; Pedro Pereira ^[1] ; Todd H. Baron ^[2] ; Guilherme Macedo ^[1]
  1. [1] Centro Hospitalar de São João. Porto, Portuga
  2. [2] University of North Carolina. Chapel Hill, North Carolina. United States
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 110, Nº. 8, 2018, págs. 500-504
• Idioma: inglés
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• Resumen

  • Background: self-expandable metal stents are often used for the palliative treatment of dysphagia in patients with advanced esophageal cancer and an anticipated limited survival. Due to previous reports of a high rate of adverse event when used long-term, concerns have been raised with regard to the use of self-expandable metal stents in patients with a longer survival. Aim: assess the role of esophageal self-expandable metal stents in patients with advanced esophageal cancer that have survived longer than six months. Methods: retrospective study of patients with advanced esophageal cancer with a self-expandable metal stent and a stent placement time greater than six months. Results: forty-two patients were followed up for 298 days. There was a clinical improvement in all patients. However, 59% of patients experienced an adverse event. The median stent patency was 236 days. Endoscopic management was attempted in all self-expandable metal related adverse events, with a clinical success rate of 100%. However, the previously treated adverse event recurred in seven patients. Multivariate analysis showed that strictures that were traversable with an ultrathin gastroscope were associated with a higher risk of adverse events (p = 0.035). Conclusions: long-term esophageal stenting in patients with advanced esophageal cancer is associated with a high prevalence of adverse events without an impact on mortality; most cases can be managed endoscopically.