Effect of chemotherapy on the outcome of self-expandable metallic stents in gastric cancer patients with malignant outlet obstruction

Abstract

A long time-to-progression and first-line chemotherapy were significant protective factors against re-stenosis. In chemotherapy-naïve gastric cancer patients with pyloric obstruction, placement of an uncovered stent followed by chemotherapy can be considered to increase stent patency.

Clinical outcomes of re-stenting in patients with stent malfunction in malignant gastric outlet obstruction

“…This different result was because 14 of 32 patients (43.8 %) had first-line chemotherapy in our study, while only 6 (6/33, 18.2 %) patients had first-line chemotherapy in a previous study [7]. First-line chemotherapy was more effective treatment for prolonged stent patency than salvage chemotherapy [17]. From these results, salvage SEMS may be beneficial, especially for patients with a primary SEMS malfunction who were administered palliative chemotherapy.…”

“…Several previous studies have reported that palliative chemotherapy was a prognostic factor for influencing the patency of primary SEMS in malignant GOO [15][16][17]. In another study, covered SEMS and chemotherapy with SEMS placement were significant prognostic factors for the patency of SEMS [10].…”

Covered versus uncovered metal stents for malignant gastric outlet obstruction: Systematic review and meta‐analysis

“…Chemotherapy after uncovered SEMS placement has been associated with longer stent patency as a result of prevention of local tumor progression, although interpretation of these findings may need caution to potential bias derived from the between‐group difference in the baseline hazard of cancer‐related death . Furthermore, tumor shrinkage as a result of effective chemotherapy and a resultant reduction in anchoring by the tumor may increase the risk of covered SEMS migration . Taken together, patients receiving intensive chemotherapy may be good candidates for uncovered SEMS.…”

Clinical outcomes of secondary gastroduodenal self‐expandable metallic stent placement by stent‐in‐stent technique for malignant gastric outlet obstruction

“…Another method is to prevent tumor ingrowth or tumor overgrowth by using a partially covered SEMS. Systemic chemotherapy is also a way to prevent local tumor progression if the patient can tolerate chemotherapy …”