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Clinical effectiveness and safety of self-expanding metal stent placement following palliative chemotherapy in patients with advanced esophageal cancer

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effect of prior chemotherapy on self-expanding metal stent (SEMS)-related complications in patients with locally advanced primary esophageal cancer.

Materials and methods

Data from patients with locally advanced primary esophageal cancer who received SEMS placement with or without prior chemotherapy were retrospectively reviewed. Patients were grouped according to prior palliative therapy: group A (n = 41) had received SEMS only, and group B (n = 64) had received palliative chemotherapy prior to SEMS placement. Patients’ age, stricture length, tumor location, and dysphagia score prior to SEMS placement were evaluated. The overall patient cohort had a median follow-up period of 129 days (range 11–463). Outcomes after SEMS placement, including technical and clinical success rates, the occurrence of complications, and overall survival, were compared.

Results

There were no significant differences between the two groups regarding patients’ age, stricture length, tumor location, and dysphagia score prior to SEMS placement. SEMS placement was technically successful in all patients, with no procedure-related complications reported. Clinical success was achieved in 95.1% of patients in group A and 96.8% of patients in group B. The duration of stent patency was significantly shorter in group B [162 days; 95% confidence interval (CI) 126.6–198.4 vs. group A (339 days; 95% CI 258.8–419.3], p = 0.001. No significant differences were seen between the two groups regarding dysphagia score improvement [group A (3.15 ± 0.57 to 1.17 ± 0.83; p < 0.001) and group B (3.17 ± 0.80 to 1.14 ± 0.79; p < 0.001); p = 0.66], complications [group A (10/41), and group B (24/64); p = 0.094], or overall survival [the median and mean overall survival periods were 105 (95% CI 30–180) and 132 days (95% CI 97–167), respectively, in group A, and 126 (95% CI 88–164) and 156 days (95% CI 132–180), respectively, in group B; p = 0.592].

Conclusion

Prior chemotherapy did not increase the risk of complications following SEMS placement in patients with locally advanced esophageal cancer. SEMS patency was significantly longer in patients who did not receive chemotherapy prior to SEMS placement.

Level of Evidence

Level 4, Case Series.

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Abbreviations

5-FU:

5-Fluorouracil

CI:

Confidence interval

HR:

Hazard ratio

OR:

Odds ratio

SEMSs:

Self-expandable metallic stents

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Funding

This study was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant No. HI15C0484 to H.Y.S.).

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Nader Bakheet, Hong-Tao Hu, Jung-Hoon Park, Sung Hwan Yoon, Wang Zhe & Ho-Young Song

  2. Biomedical Engineering Research Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Jung-Hoon Park

  3. Department of Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Jae Yong Jeon

  4. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Sung-Bae Kim

  5. Department of Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju-si, Chonbuk, 54907, Republic of Korea

    Kun Yung Kim

  6. Department of Gastrointestinal Endoscopy and Liver Unit, Kasr Al-Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt

    Nader Bakheet

  7. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

    Ho-Young Song

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  1. Nader Bakheet
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Correspondence to Ho-Young Song.

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All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This study has obtained institutional IRB approval and the need for informed consent was waived.

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Nader Bakheet and Hong-Tao Hu are co-first authors.

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Bakheet, N., Hu, HT., Park, JH. et al. Clinical effectiveness and safety of self-expanding metal stent placement following palliative chemotherapy in patients with advanced esophageal cancer. Abdom Radiol 45, 563–570 (2020). https://doi.org/10.1007/s00261-019-02245-3

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