Abstract | BACKGROUND: Placement of self-expanding stents is an effective palliation for dysphagia in non-resectable oesophageal or proximal gastric cancer. The aim of this analysis was to assess the efficacy of temporary stent placement for dysphagia relief during neo-adjuvant treatment for locally advanced disease. METHODS: RESULTS: Instant dysphagia relief was achieved in 37 (97.4%) of 38 patients. Dysphagia scores declined from mean 3.0 +/- 0.7 before stent placement to 0.6 +/- 0.9 at restaging. After completion of the neo-adjuvant therapy 20 (52.6%) of the 38 patients underwent resection of the tumour, 5 patients (13.2%) underwent primary resection without receiving chemotherapy while 12 patients (31.6%) did not undergo surgery. Stent-related complications were observed as perforation (n = 1), mediastinitis (n = 1), tracheo-oesophageal fistula (n = 2), bleeding (n = 1) and jejunal perforation caused by a migrated stent (n = 1). Serum albumin significantly decreased in patients with progressive disease despite successful stenting (40.0 +/- 4.9 mg/dl versus 29.7 +/- 6.4 mg/dl, p < 0.05) while stable albumin levels were found in patients who underwent surgery (39.9 +/- 4.3 mg/dl versus 39.1 +/- 3.8 mg/dl, p = 0.484). CONCLUSION: Placement of self-expanding stents is highly effective for instant dysphagia relief, enabling adequate oral nutrition during neo-adjuvant therapy, but is limited by a high re-intervention rate.
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Authors | Felix B Langer, Sebastian F Schoppmann, Gerhard Prager, Florian Tomaselli, Ursula Pluschnig, Michael Hejna, Rainer Schmid, Johannes Zacherl |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 17
Issue 2
Pg. 470-5
(Feb 2010)
ISSN: 1534-4681 [Electronic] United States |
PMID | 19859771
(Publication Type: Journal Article)
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Topics |
- Adenocarcinoma
(pathology, therapy)
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Cardia
(drug effects, radiation effects, surgery)
- Combined Modality Therapy
- Deglutition Disorders
(etiology, surgery)
- Esophageal Neoplasms
(pathology, therapy)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasms, Squamous Cell
(pathology, therapy)
- Palliative Care
- Radiotherapy Dosage
- Stents
- Survival Rate
- Treatment Outcome
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