Esophageal cancer is now the sixth leading cause of death from cancer worldwide [1, 2]. During the past three decades, important changes have occurred in the epidemiologic patterns associated with this disease [1]. Due to the distensible characteristics of the esophagus, patients may not recognize any symptoms until 50% of the luminal diameter is compromised, explaining why cancer of the esophagus is generally associated with late presentation and poor prognosis [3]. Esophageal cancer has a poor outcome, with an overall 5 year survival rate of less than 10%, and fewer than 50% of patients are suitable for resection at presentation. As a result palliation is the best option in this group of patients [3, 4]. The aims of palliation are maintenance of oral intake, minimizing hospital stay, relief of pain, elimination of reflux and regurgitation, and prevention of aspiration [3, 5, 6]. For palliative care, current treatment options include thermal ablation [7–9], photodynamic therapy [10–12], radiotherapy [13], chemotherapy [14, 15], chemical injection therapy [16–18], argon beam or bipolar electrocoagulation therapy [19], enteral feeding (nasogastric tube/percutaneous endoscopic gastrostomy) [20–22], and intubation (self-expanding metal stents (SEMS) or semi-rigid prosthetic tubes) [5, 6, 23–26] with different success and complications rates.
Similar content being viewed by others
References
PC Enzinger RJ Mayer (2003) ArticleTitleMedical progress: Esophageal cancer N Engl J Med 349 2241–2252 Occurrence Handle10.1056/NEJMra035010 Occurrence Handle1:CAS:528:DC%2BD3sXps1WhsL8%3D Occurrence Handle14657432
P Pisani DM Parkin F Bray et al. (1999) ArticleTitleEstimates of the worldwide mortality from 25 cancers in 1990 Int J Cancer 83 18–29 Occurrence Handle10.1002/(SICI)1097-0215(19990924)83:1<18::AID-IJC5>3.0.CO;2-M Occurrence Handle1:STN:280:DyaK1MzotVaiuw%3D%3D Occurrence Handle10449602
AK Kubba N Krasner (2000) ArticleTitleAn update in the palliative management of malignant dysphagia Eur J Surg Oncol 26 116–129 Occurrence Handle10.1053/ejso.1999.0754 Occurrence Handle1:STN:280:DC%2BD3c3htFCntA%3D%3D Occurrence Handle10744928
R Mason (2001) ArticleTitlePalliation of oesophageal cancer Surg Oncol 10 123–126 Occurrence Handle10.1016/S0960-7404(01)00026-3 Occurrence Handle1:STN:280:DC%2BD38%2FgsVOjuw%3D%3D Occurrence Handle11750231
R Morgan A Adam (2001) ArticleTitleEsophageal stents: An update Semin Interv Radiol 18 251–264 Occurrence Handle10.1055/s-2001-17933
SH Lee (2001) ArticleTitleThe role of oesophageal stenting in the non-surgical management of oesophageal strictures Br J Radiol 74 891–900 Occurrence Handle1:STN:280:DC%2BD3MrmvVWntQ%3D%3D Occurrence Handle11675304
A Adam J Ellul AF Watkinson et al. (1997) ArticleTitlePalliation of inoperable esophageal carcinoma: A prospective randomised trial of laser therapy and stent placement Radiology 202 344–348
AM Gevers E Macken M Hiele et al. (1998) ArticleTitleA comparison of laser therapy, plastic stents and expandable metal stents for palliation of malignant dysphagia in patients without a fistula Gastrointest Endosc 48 383–388 Occurrence Handle1:STN:280:DyaK1M%2FgtVSnuw%3D%3D Occurrence Handle9786110
DS Tan RC Mason A Adam et al. (1996) ArticleTitleMinimally invasive therapy for advanced oesophageal malignancy Clin Radiol 51 828–836 Occurrence Handle1:STN:280:ByiC38jps1w%3D Occurrence Handle8972646
SK Heier KA Rothman LM Heier et al. (1995) ArticleTitlePhotodynamic therapy for obstructing oesophageal cancer: Light dosimetry and randomised comparisons with Nd:YAG laser therapy Gastroenterology 109 63–72 Occurrence Handle1:STN:280:ByqA3Mjls10%3D Occurrence Handle7541003
CJ Lightdale SK Heier ME Manon (1995) ArticleTitlePhotodynamic therapy with porfimer sodium versus thermal ablation with Nd:YAG laser for palliation of esophageal cancer: A multi-centre randomised trial Gastrointest Endosc 42 507–512 Occurrence Handle1:STN:280:BymB3srot1I%3D Occurrence Handle8674919
JD Luketich NA Christine PO Buenaventura et al. (2000) ArticleTitleEndoscopic photodynamic therapy for obstructing oesophageal cancer: 77 cases over a 2 year period Surg Endosc 14 653–657 Occurrence Handle10.1007/s004640000222 Occurrence Handle1:STN:280:DC%2BD3M7gvFWmuw%3D%3D Occurrence Handle10948303
R Earlam JR Cunha-Melo (1980) ArticleTitleOesophageal squamous cell carcinoma. A critical review of radiotherapy Br J Surg 67 457–461 Occurrence Handle1:STN:280:Bi6D383itVQ%3D Occurrence Handle6158354
A Bamias M Hill D Cunningham et al. (1996) ArticleTitleEpirubicin, cisplatin and protracted venous infusional 5 fluorouracil for oesophagogastric adenocarcinoma: Response, toxicity, quality of life and survival Cancer 77 1978–1985
M Highley F Parnis GA Trotter et al. (1994) ArticleTitleCombination chemotherapy with epirubicin, cisplatin and 5-fluorouracil for the palliation of advanced gastric and oesophageal adenocarcinoma Br J Surg 81 1763–1765 Occurrence Handle1:STN:280:ByqC38fnsVQ%3D Occurrence Handle7530150
LU Nwokolo JJ Payne-James DBA Silk et al. (1994) ArticleTitlePalliation of malignant dysphagia by ethanol induced tumour necrosis Gut 35 299–303 Occurrence Handle1:STN:280:ByuB3c%2FmsFU%3D Occurrence Handle7512062
JJ Payne-James RC Spiller JJ Misiewicz (1990) ArticleTitleUse of ethanol induced tumour necrosis to palliate dysphagia in patients with esophagogastric cancer Gastrointest Endosc 36 43–46 Occurrence Handle1:STN:280:By%2BC1crgtlY%3D Occurrence Handle1690158
SCS Chung HT Leong CYC Choi (1994) ArticleTitlePalliation of malignant esophageal obstruction by endoscopic alcohol injection Endoscopy 26 275–277 Occurrence Handle1:STN:280:ByuA2MjhtFI%3D Occurrence Handle7521294
H Heindorff M Wojdemann T Bisgaard et al. (1998) ArticleTitleEndoscopic palliation of inoperable cancer of the esophagus or cardia by organ electrocoagulation Scand J Gastroenterol 33 21–23 Occurrence Handle1:STN:280:DyaK1c7kvFGntQ%3D%3D Occurrence Handle9489903
TM Mekhail DJ Adelstein LA Rybicki et al. (2001) ArticleTitleEnteral nutrition during the treatment of head and neck carcinoma: Is a percutaneous endoscopic gastrostomy tube preferable to nasogastric tube? Cancer 91 1785–1790
N Magne PY Marcy C Foa et al. (2001) ArticleTitleComparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients Eur Arch Otorhinolaryngol 258 89–92 Occurrence Handle10.1007/s004050000311 Occurrence Handle1:STN:280:DC%2BD3MrjslWgug%3D%3D Occurrence Handle11307612
C Ripamonti BT Gemlo F Bozzetti et al. (1996) ArticleTitleRole of enteral nutrition in advanced cancer patients: Indications and contraindications of the different techniques employed Tumori 82 302–308 Occurrence Handle1:STN:280:ByiD2cngtlw%3D Occurrence Handle8890960
CA O’Donell GM Fullarton E Watt et al. (2002) ArticleTitleRandomized clinical trial comparing self-expanding metallic stents with plastic endoprostheses in the palliation of oesophageal cancer Br J Surg 89 985–992 Occurrence Handle10.1046/j.1365-2168.2002.02152.x Occurrence Handle12153622
F Mosca A Consoli A Stracqualursi et al. (2003) ArticleTitleComparative retrospective study on the use of plastic prostheses and self-expanding metal stents in the palliative treatment of malignant strictures of the esophagus and cardia Dis Esoph 16 119–125 Occurrence Handle10.1046/j.1442-2050.2003.00308.x Occurrence Handle1:STN:280:DC%2BD3s3ps1ahsA%3D%3D
GD Palma ParticleDe E di Matteo E Romano et al. (1996) ArticleTitlePlastic prosthesis versus expandable metal stents for palliation of inoperable oesophageal thoracic carcinoma: A controlled prospective study Gastrointest Endosc 43 478–482 Occurrence Handle8726762
W Cwikiel KG Tranberg M Cwikiel et al. (1998) ArticleTitleMalignant dysphagia: Palliation with oesophageal stents—long term results in 100 patients Radiology 207 513–518
CJ Symonds (1885) ArticleTitleA case of malignant stricture of the oesophagus illustrating the use of a new form of oesophageal catheter Trans Clin Soc Lond 18 155–158
B Acunas I Rozanes S Akpinar et al. (1996) ArticleTitlePalliation of malignant esophageal strictures with self-expanding Nitinol stents: Drawbacks and complications Radiology 199 648–652
HU Laasch DA Nicholson CL Kay et al. (1998) ArticleTitleThe clinical effectiveness of the Gianturco oesophageal stent in malignant oesophageal obstruction Clin Radiol 53 666–672 Occurrence Handle1:STN:280:DyaK1cvjvVWisg%3D%3D Occurrence Handle9766720
RA Morgan ERE Denton AF Watkinson et al. (1996) ArticleTitleMetallic stenting of malignant esophageal strictures (abstract) Cardiovasc Intervent Radiol 19 IssueID[Suppl] 69
HY Song YS Do YM Han et al. (1998) ArticleTitleCovered, expandable oesophageal metallic stent tubes: Experience in 119 patients Radiology 207 513–518 Occurrence Handle9577503
AF Watkinson J Ellul K Entwistle et al. (1995) ArticleTitlePlastic-covered metallic endoprostheses in the management of esophageal perforation in patients with esophageal carcinoma Clin Radiol 50 304–309 Occurrence Handle1:STN:280:ByqB283jtl0%3D Occurrence Handle7538058
YS Do HY Song BH Lee et al. (1993) ArticleTitleEsophagorespiratory fistula associated with esophageal cancer: Treatment with a Gianturco stent tube Radiology 187 673–677
NK Gupta CE Boylan R Razzaq et al. (1999) ArticleTitleSelf expanding oesophageal metal stents for the palliation of dysphagia due to extrinsic compression Eur Radiol 9 1893–1897 Occurrence Handle10.1007/s003300050943 Occurrence Handle1:STN:280:DC%2BD3c%2FntVCrsA%3D%3D Occurrence Handle10602971
RR Saxon RE Barton J Rösch (1994) ArticleTitleComplications of oesophageal stenting and balloon dilatation Semin Interv Radiol 11 276–282
M Faruggia RA Morgan JA Latham et al. (1997) ArticleTitlePerforation of the esophagus secondary to insertion of covered Wallstent endoprostheses Cardiovasc Intervent Radiol 20 428–430
M Tyrell G Trotter A Adam et al. (1995) ArticleTitleIncidence and management of laser-associated oesophageal perforation Br J Surg 82 1257–1258 Occurrence Handle7552012
J Broto M Asensio JM Vernet (2003) ArticleTitleResults of a new technique in the treatment of severe esophageal stenosis in children: Polyflex stents J Pediatr Gastroent Nutr 37 203–206 Occurrence Handle10.1097/00005176-200308000-00024
Y Nishimura K Nagata S Katano et al. (2003) ArticleTitleSevere complications in advanced esophageal cancer treated with radiotherapy after intubation of esophageal stents: A questionnaire survey of the Japanese Society for Esophageal Diseases Int J Radiat Oncol Biol Phys 56 1327–1332 Occurrence Handle10.1016/S0360-3016(03)00198-6 Occurrence Handle12873677
M Yakami M Mitsumori H Sai et al. (2003) ArticleTitleDevelopment of severe complications caused by stent placement followed by definitive radiation therapy for T4 esophageal cancer Int J Clin Oncol 8 395–398 Occurrence Handle10.1007/s10147-003-0356-2 Occurrence Handle14663644
AF Watkinson J Ellul K Entwisle et al. (1995) ArticleTitleOesophageal carcinoma: Initial results of palliative treatment with covered self-expanding endoprostheses Radiology 195 821–827
A Schamassmann C Meyenberger J Knuchel et al. (1997) ArticleTitleSelf-expanding metal stents in malignant esophageal obstruction: A comparison between two stents types Am J Gastroenterol 92 400–406 Occurrence Handle9068458
I Raijman I Siddiqui J Ajani et al. (1998) ArticleTitlePalliation of malignant dysphagia and fistulae with coated expandable metal stents: Experience with 101 patients Gastrointest Endosc 48 172–179 Occurrence Handle1:STN:280:DyaK1czotFyrsQ%3D%3D Occurrence Handle9717783
FW Winkelbauer R Schofl B Niederle et al. (1996) ArticleTitlePalliative treatment of obstructing esophageal cancer with nitinol stents: Value, safety, and long-term results AJR Am J Roentgenol 166 79–84 Occurrence Handle1:STN:280:BymC3M%2FltVY%3D Occurrence Handle8571911
GJ O’Sullivan A Grundy (1999) ArticleTitlePalliation of malignant dysphagia with expanding metal stents J Vasc Interv Radiol 10 346–351 Occurrence Handle1:STN:280:DyaK1M3gtVehtg%3D%3D Occurrence Handle10102201
CD Roseveare P Patel N Simmonds et al. (1998) ArticleTitleMetal stents improve dysphagia, nutrition and survival in malignant oesophageal stenosis: A randomised controlled trial comparing modified Gianturco Z stents with plastic Atkinson tubes Eur J Gastroenterol Hepatol 10 653–657 Occurrence Handle1:STN:280:DyaK1cvhsF2nsA%3D%3D Occurrence Handle9744693
PD Siersema CJ Hop J Dees et al. (1998) ArticleTitleCoated self-expanding stent versus latex prostheses for esophagogastric cancer with special reference to prior radiation and chemotherapy: A controlled prospective study Gastrointest Endosc 46 113–119
R Kozarek S Raltz WR Brugge et al. (1996) ArticleTitleProspective multicentre trial of oesophageal Z-stent placement for malignant dysphagia and tracheoesophageal fistula Gastrointest Endosc 44 562–567 Occurrence Handle1:STN:280:ByiD1cfit1A%3D Occurrence Handle8934162
D Wengrower A Fiorini J Valero et al. (1998) ArticleTitleEsophacoil: Long term results in 81 patients Gastrointest Endosc 48 376–382 Occurrence Handle1:STN:280:DyaK1M%2FgtVSnug%3D%3D Occurrence Handle9786109
E Olsen R Thyregaard J Kill et al. (1999) ArticleTitleEsophageal expanding stent in the management of patients with non-resectable malignant esophageal or cardiac neoplasm: A prospective study Endosc 31 417–420 Occurrence Handle10.1055/s-1999-43 Occurrence Handle1:STN:280:DyaK1Mvit1ylug%3D%3D
KS Dua R Kozarek J Kim et al. (2001) ArticleTitleSelf expanding metal esophageal stent with anti-reflux mechanism Gastrointest Endosc 53 603–613 Occurrence Handle10.1067/mge.2001.114054 Occurrence Handle1:STN:280:DC%2BD3MvkvVKksw%3D%3D Occurrence Handle11323586
HY Song HY Jung SI Park et al. (2000) ArticleTitleCovered retrievable expandable Nitinol stents in patients with benign esophageal strictures: Initial experience Radiology 217 551–557
JF Bartelsman MJ Bruno AJ Jensema et al. (2000) ArticleTitlePalliation of patients with esophagogastric neoplasm by insertion of a covered expandable modified Gianturco-Z endoprosthesis: Experiences in 153 patients Gastrointest Endosc 51 134–138 Occurrence Handle1:STN:280:DC%2BD3c7hslOmsQ%3D%3D Occurrence Handle10650253
HY Song SI Park HY Jung et al. (1997) ArticleTitleBenign and malignant esophageal strictures: Treatment with a polyurethane-covered retrievable expandable metallic stent Radiology 203 747–752
G Costamagna SK Shak A Tringali et al. (2003) ArticleTitleProspective evaluation of a new self-expanding plastic stent for inoperable esophageal strictures Surg Endosc 17 891–895 Occurrence Handle10.1007/s00464-002-9098-x Occurrence Handle1:STN:280:DC%2BD3s3nvFaksA%3D%3D Occurrence Handle12618935
AJ Dormann P Eisandrath B Wigginghaus et al. (2003) ArticleTitlePalliation of esophageal carcinoma with a new self-expanding plastic stent Endoscopy 35 207–211 Occurrence Handle10.1055/s-2003-37252 Occurrence Handle1:STN:280:DC%2BD3s%2Fntlentg%3D%3D Occurrence Handle12584638
A Adam R Morgan J Ellul et al. (1998) ArticleTitleA new design of the esophageal Wallstent endoprosthesis resistant to distal migration AJR Am J Roentgenol 170 1477–1482 Occurrence Handle1:STN:280:DyaK1c3ntVeiuw%3D%3D Occurrence Handle9609156
T Sabharwal MS Hamady S Chui et al. (2003) ArticleTitleA randomized prospective comparison of the Flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma Gut 52 922–26 Occurrence Handle10.1136/gut.52.7.922 Occurrence Handle1:STN:280:DC%2BD3s3nsFaguw%3D%3D Occurrence Handle12801944
M Kocher M Dlouhy C Neoral et al. (1998) ArticleTitleEsophageal stent with antireflux valve for tumors involving the cardia: Work in progress J Vasc Interv Radiol 9 1007–1010 Occurrence Handle1:STN:280:DyaK1M%2FltlOrtw%3D%3D Occurrence Handle9840050
AA Nicholson CMS Royston K Wedgewood et al. (1995) ArticleTitlePalliation of malignant oesophageal perforation and proximal oesophageal malignant dysphagia with covered metal stents Clin Radiol 50 11–14 Occurrence Handle1:STN:280:ByqC3snlvFY%3D Occurrence Handle7530613
RA Morgan JPM Ellul ERE Denton et al. (1997) ArticleTitleMalignant esophageal fistulas and perforations: Management with plastic-covered metallic endoprostheses Radiology 204 527–532
T Sabharwal JP Morales R Salter et al. (2004) ArticleTitleEsophageal cancer: Self-expanding metallic stents Abdom Imaging 29 1–9
W Mayoral D Fleischer J Salcedo et al. (2000) ArticleTitleNon-malignant obstruction is a common problem with metal stents in the treatment of oesophageal cancer Gastrointest Endosc 51 556–559 Occurrence Handle10.1067/mge.2000.104651 Occurrence Handle1:STN:280:DC%2BD3c3msF2mtw%3D%3D Occurrence Handle10805841
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sabharwal, T., Morales, J.P., Irani, F.G. et al. Quality Improvement Guidelines for Placement of Esophageal Stents. Cardiovasc Intervent Radiol 28, 284–288 (2005). https://doi.org/10.1007/s00270-004-0344-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-004-0344-6