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Palliative interventions for patients with incurable locally advanced or metastatic thoracic esophageal carcinoma

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Abstract

Background

The aim of this study was to assess the clinical outcomes of palliative interventions for patients with incurable locally advanced or metastatic esophageal carcinoma.

Methods

A total of 131 patients with thoracic esophageal carcinoma who underwent palliative interventions were enrolled. Insertion of a self-expandable metallic stent (SEMS), tube enterostomy for enteral nutrition (EN), and palliative esophagectomy (PE) were performed in 38, 65, and 28 patients, respectively. The clinicopathological characteristics and clinical outcomes of each group were retrospectively reviewed.

Results

Patients in the EN group frequently received chemoradiotherapy (P < 0.01). SEMS insertion, but not PE or EN, improved the mean dysphagia score after the intervention (P < 0.01). For the SEMS, EN, and PE groups, the occurrence of intervention-related complications was 31.6, 10.8, and 96.4%, respectively, the median survival time was 88, 208, and 226 days (P < 0.01), and the mean ratio of duration of home care to survival time was 28.9, 38.5, and 39.6% (P = 0.95).

Conclusions

SEMS insertion effectively relieved obstructive symptoms, but had no survival benefit. Tube enterostomy showed a low complication rate and has the potential to improve survival in combination with additional treatment, with no palliation of obstructive symptoms.

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Tomoyuki Kakuta, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa & Toshifumi Wakai

  2. Department of Digestive and General Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan

    Shin-ichi Kosugi

  3. Department of Surgery, Sanjo General Hospital, Niigata, Japan

    Tatsuo Kanda

Authors
  1. Tomoyuki Kakuta
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  2. Shin-ichi Kosugi
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  3. Hiroshi Ichikawa
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  4. Takaaki Hanyu
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  5. Takashi Ishikawa
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  6. Tatsuo Kanda
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  7. Toshifumi Wakai
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Corresponding author

Correspondence to Tomoyuki Kakuta.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent or substitute for it was obtained from all patients for being included in this study.

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Kakuta, T., Kosugi, Si., Ichikawa, H. et al. Palliative interventions for patients with incurable locally advanced or metastatic thoracic esophageal carcinoma. Esophagus 16, 278–284 (2019). https://doi.org/10.1007/s10388-019-00665-0

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  • DOI: https://doi.org/10.1007/s10388-019-00665-0

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