Role of fluoroscopic guided self expandable metallic stents in the management of malignant esophageal strictures

Shaker, Mohamed; Deif, Ahmed; Abdelaal, Amr

doi:10.1016/j.ejrnm.2016.06.013

Cited by 2 publications

(5 citation statements)

References 13 publications

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“…Stenting: Esophageal self-expandable metallic stent (SEMS), are used for palliative treatment of malignant dysphagia or esophago-respiratory fistula. We had 10 different studies with a combined total study population of 1699 patients that reported a marked improvement in symptoms of malignant dysphagia and/or esophago-respiratory fistula[103,107,108,119,120,123,124,128,133,134]. The type of stents used includes Ultraflex (Boston Scientific Corporation, MA, United States), AT&M SEMS (Advanced Technology and Materials, Beijing, China), Wallstent (Boston Scientific Corporation, MA, United States) among others[108,120,124].…”

Section: Resultsmentioning

confidence: 99%

“…The two studies reported stent application associated mortality of 3.5% in a study population of 58 patients[107] and of 0.5% in a study of 951 patients[124]. Three studies reported on the morbidity associated with this same intervention[119,120,124]. The early morbidities reported include oesophageal perforation, bleeding, chest pains and death while the late morbidities include migration, Tracheo-Oesophageal Fistula (TOF) and tumour overgrowth[119,120,124].…”

Section: Resultsmentioning

confidence: 99%

“…The mean dysphagia score was measured using the Mellow and Pinka’s dysphagia score and was reported to improve after stent application in 10 studies[107,108,115,119,120,123,124,128,133,134]. A study with a population of 40 patients had the best mean dysphagia score improvement which was from a score of 3 to a score of 0[108].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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BACKGROUND Esophageal cancer (EC) is associated with a poor prognosis, particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease. AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity, and socio-economic challenges faced on the African continent. METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology, risk factors, management and outcomes of EC. A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer, and the Cancer in Sub-Saharan reports. We searched EMBASE, PubMed, Web of Science, and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved. Random effects meta-analyses were used to assess heterogeneity between studies and to obtain odds ratio (OR) of the associations between EC and risk factors; and incidence rate ratios for EC between sexes with their respective 95% confidence intervals (CI). RESULTS The incidence of EC is higher in males than females, except in North Africa where it is similar for both sexes. The highest age-standardized rate is from Malawi (30.3 and 19.4 cases/year/100000 population for males and females, respectively) followed by Kenya (28.7 cases/year/100000 population for both sexes). The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old. Meta-analysis shows a strong association with tobacco (OR 3.15, 95%CI: 2.83-3.50). There was significant heterogeneity between studies on alcohol consumption (OR 2.28, 95%CI: 1.94-2.65) and on low socioeconomic status (OR 139, 95%CI: 1.25-1.54) as risk factors, but these could also contribute to increasing the incidence of EC. The best treatment outcomes were with esophagectomy with survival rates of 76.6% at 3 years, and chemo-radiotherapy with an overall combined survival time of 267.50 d. CONCLUSION Africa has high incidence and mortality rates of EC, with preventable and non-modifiable risk factors. Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption. Management requires a multidisciplinary approach, and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Asombang¹,

Chishinga²,

Nkhoma³

et al. 2019

WJG

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“…20 Of the 37 nonrandomized studies, 17 reported on palliative luminal and surgical interventions ( Table 1). Ten of these studies reported on self-expandable metallic stents (SEMS) 6,[20][21][22][23][24][25][26][27][28] ; five on rigid plastic stents, laser treatment or dilation [29][30][31][32][33] ; and two on retrosternal gastric bypass. 34,35 Four studies reported on palliative radiotherapy, 18,20,32,36 six studies on chemotherapy 32,37-41 and three studies on concurrent chemoradiotherapy 32,42,43 (Table 2).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…These studies have consistently demonstrated the safety and efficacy of SEMS across a variety of settings in Africa. Procedural mortality with SEMS has ranged from 0% to 10%, [20][21][22][23][24][25][26]28 mean improvements in dysphagia scores from 1.9 to 3.0, [21][22][23][24]26,28 and median OS from 7 to 39 weeks. 6,[20][21][22][23][24][26][27][28]…”

Section: Palliative Luminal and Surgical Interventionsmentioning

confidence: 99%

Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

Buckle

Mahapatra

Mwachiro

et al. 2020

Intl Journal of Cancer

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Esophageal cancer (EC) is a leading cause of cancer morbidity and mortality in Africa. Despite the high burden of disease, optimal management strategies for EC in resource‐constrained settings have yet to be established. This systematic review evaluates the literature on treatments for EC throughout Africa and compares the efficacy and safety of varying treatment strategies in this context (PROSPERO CRD42017071546). PubMed, Embase and African Index Medicus were searched for studies published on treatment strategies for EC in Africa from 1980 to 2020. Searches were supplemented by examining bibliographies of included studies and relevant conference proceedings. Methodological quality/risk of bias was assessed using the Cochrane Risk‐of‐Bias tool and the Newcastle‐Ottawa Scale. Forty‐six studies were included. Case series constituted the majority of studies: 13 were case series reporting on outcomes of esophagectomies, 17 on palliative luminal or surgical interventions, four on radiotherapy and three on concurrent chemoradiation. Nine randomized controlled trials were identified, of which four prospectively compared different treatment modalities (one investigating radiotherapy vs chemoradiation, three evaluating rigid plastic stents vs other treatments). This review summarizes the research on EC treatments in Africa published over the last four decades and outlines critical gaps in knowledge related to management in this context. Areas in need of further research include (a) evaluation of the safety and efficacy of neoadjuvant therapy in patients with locally advanced disease; (b) strategies to improve long‐term survival in patients treated with definitive chemoradiation; and (c) the comparative effectiveness of modern palliative interventions, focusing on quality of life and survival as outcome measures.

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Role of fluoroscopic guided self expandable metallic stents in the management of malignant esophageal strictures

Cited by 2 publications

References 13 publications

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Systematic review of esophageal cancer in Africa: Epidemiology, risk factors, management and outcomes

Optimal management of esophageal cancer in Africa: A systemic review of treatment strategies

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