Natural course of inoperable esophageal cancer treated with metallic expandable stents: Quality of life and cost‐effectiveness analysis

Xinopoulos, Dimitrios; Dimitroulopoulos, Dimitrios; Moschandrea, Ioanna; Skordilis, Panagiotis; Bazinis, A; Kontis, Marios; Paraskevas, Ioannis; Kouroumalis, Elias; Paraskevas, E.

doi:10.1111/j.1440-1746.2004.03507.x

Cited by 38 publications

(29 citation statements)

References 43 publications

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“…The mean survival and the cost were similar 264 265. In a small prospective randomised trial comparing stents with laser followed by palliative radiotherapy, there was no difference in survival but the costs of laser and radiotherapy were higher than stents 266.…”

Section: Neoadjuvant Perioperative (Neoadjuvant and Adjuvant) And Admentioning

confidence: 91%

Guidelines for the management of oesophageal and gastric cancer

Allum

Blazeby

Griffin

et al. 2011

Gut

619

315

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Section: Neoadjuvant Perioperative (Neoadjuvant and Adjuvant) And Admentioning

confidence: 91%

Guidelines for the management of oesophageal and gastric cancer

Allum

Blazeby

Griffin

et al. 2011

Gut

619

315

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“…In recent times, placement of a self‐expanding metal stent (SEMS) has become established as a treatment modality for the palliation of malignant dysphagia. SEMS relieves dysphagia rapidly and improves the nutritional status 5,6 . However, whether it has any impact on the QOL of such patients is not known.…”

Section: Introductionmentioning

confidence: 99%

Palliative stenting for relief of dysphagia in patients with inoperable esophageal cancer: impact on quality of life

Madhusudhan

Saluja

Pal

et al. 2009

Diseases of the Esophagus

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The aim of palliation in patients with inoperable esophageal cancer is to relieve dysphagia with minimal morbidity and mortality, and thus improve quality of life (QOL). The use of a self-expanding metal stent (SEMS) is a well-established modality for palliation of dysphagia in such patients. We assessed the QOL after palliative stenting in patients with inoperable esophageal cancer. Thirty-three patients with dysphagia due to inoperable esophageal cancer underwent SEMS insertion between October 2004 and December 2006. All patients had grade III/IV dysphagia and locally advanced unresectable cancer (n = 13), distant metastasis (n = 14), or comorbid conditions/poor general health status precluding a major surgical procedure (n = 6). Patients with grade I/II dysphagia and those with carcinoma of the cervical esophagus were excluded. The QOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 (version 3) and EORTC QLQ-Esophagus (OES) 18 questionnaire (a QOL scale specifically designed for esophageal diseases) before and at 1, 4, and 8 weeks after placement of the stent. The mean age of the patients was 56 (range 34-78) years, and 22 were men. A covered SEMS was used in all patients. The most common site of malignancy was the lower third of the esophagus (n = 18, 55%). In 23 (77%) patients, the stent crossed the gastroesophageal junction. Seven patients required a reintervention for stent block (n = 5) and stent migration (n = 2). Dysphagia improved significantly immediately after stenting, and this improvement persisted until 8 weeks (16.5 vs. 90.6; P < 0.01). The global health status (5.8 vs. 71.7; P < 0.01) and all functional scores improved significantly after stenting from baseline until 8 weeks. Except pain (14.1 vs. 17.7; P = 0.67), there was significant improvement in deglutition (22.7 vs. 2.0; P < 0.01), eating (48 vs. 12.6; P < 0.01), and other symptom scales (19.7 vs. 12.1; P = 0.04) following stenting. The median survival was 4 months (3-7 months). Palliative stenting using SEMS resulted in significant improvement in all scales of QOL without any mortality and acceptable morbidity.

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“…(18) The reason for this low incidence in our study may be the very narrow stricture causing absolute dysphagia and minimal use of dilatation causing the stents to be tightly adherent to the tumour. Even though the incidence of oesophageal perforation is rare, (19) we had one incidence of perforation. Other complications like chest pain, foreign body sensation etc.…”

Section: Discussionmentioning

confidence: 89%

Effectiveness of Self-Expanding Metallic Stents in the Palliation of Absolute Dysphagia in Carcinoma Oesophagus- A 1-Year Follow-Up Study

Joseph¹,

Vijayan²,

Sudhiraj³

2018

jemds

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BACKGROUND Palliation of dysphagia is the primary goal in the care of inoperable oesophageal carcinoma and the usual option is palliative chemoradiotherapy. But radiation induced complications made chemoradiation a less favourable option for managing dysphagia. Rapid improvement in dysphagia with minimal complications and technical simplicity made SEMS the primary option in the palliation of dysphagia.The aim of this study was to assess the outcomes of inoperable oesophageal malignancy presented with absolute dysphagia, who were treated with SEMS placement. The objective of our study was to assess the effectiveness of SEMS in palliation of Grade 4 dysphagia due to oesophageal carcinoma. Other aims were the technical success rate, complications and survival.

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Natural course of inoperable esophageal cancer treated with metallic expandable stents: Quality of life and cost‐effectiveness analysis

Cited by 38 publications

References 43 publications

Guidelines for the management of oesophageal and gastric cancer

Guidelines for the management of oesophageal and gastric cancer

Palliative stenting for relief of dysphagia in patients with inoperable esophageal cancer: impact on quality of life

Effectiveness of Self-Expanding Metallic Stents in the Palliation of Absolute Dysphagia in Carcinoma Oesophagus- A 1-Year Follow-Up Study

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