Outcome of Stent Placement for Advanced and Recurrent Thoracic Esophageal Cancer

Toshiaki Tanaka, Susumu Sueyoshi, Hiroko Sasahara, Yuichi Tanaka, Naoki Mori, Takeshi Nagano, Kazuo Shirouzu and Hiromasa Fujita

Department of Surgery, Kurume University School of Medicine

Malignant strictures and fistula of the esophagus and tracheobronchus adversely affect the quality of life (QOL) and prognosis in patients with incurable esophageal carcinoma. Stenting is one of the best palliation modalities for improve QOL. We evaluated the effect of intraesophageal and intratracheal stenting in patients with stricture and/or fistula of esophagus and trachea due to thoracic esophageal carcinoma. Patients and Methods: Subjects were 61 with advanced esophageal carcinoma treated with stenting from 1995 through 2003, 36 with esophageal stent, 17 with tracheal stent, and 8 with both. They were evaluated based on the prognosis and QOL. An esophageal stent was placed as final treatment after chemoradiation therapy, and 7 out of those treated with the bronchial stent underwent chemoradiation therapy after stenting. Results: Median survival after stenting was 2.5 months in patients with an esophageal stent, 9.6 months in patients with a tracheal stent, and 3.4 months in patients treated with both stents. Food ingestion was improved in 80% of patients with the esophageal stent, and about half were discharged. Worsening of performance status (PS) was seen after stenting in 3 out of 17 patients with PS3. Tracheal stent placement improved the PS in 15 out of 17 patients, resulting in the improvement of the QOL. Responders for chemoradiation therapy after trachial stenting survived for a long time. Conclusions: Esophageal stenting improved food ingestion and QOL in patients with PS≤2. It did not always result in improved QOL in those patients with PS3. QOL improved in most of patients treated with the trachial stents, and long survival is expected in responders to chemoradiation therapy after stenting.

Key words
esophageal cancer, esophageal stent, tracheal stent

Reprint requests
Toshiaki Tanaka Department of Surgery, Kurume University School of Medicine
67 Asahimachi, Kurume, 830-0011 JAPAN

Accepted
February 22, 2006

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