Stent placement or brachytherapy for palliation of dysphagia from esophageal cancer: a prognostic model to guide treatment selection

Steyerberg, Ewout W.; Homs, Marjolein Y.V.; Stokvis, Annemieke; Essink‐Bot, Marie‐Louise; Siersema, Peter D.

doi:10.1016/s0016-5107(05)01587-7

Cited by 87 publications

(71 citation statements)

References 37 publications

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“…[9] Such characteristics are routinely collected at time of diagnosis and staging, and given their well-established value, provide a logical backbone on which to base prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…[1,7,8] Although of limited benefit in patients with extremely poor prognosis, such treatments may be more appropriate for patients with a reasonable life expectancy. [1,9] Identifying tumour and host characteristics which may guide prognosis in this patient group would be of use in differentiating between such different treatment options.…”

Section: Introductionmentioning

confidence: 99%

“…[9,10] Similarly, markers of poor nutrition are common in patients with OG cancer, [11] and predict short-term survival; indeed, need for intensive nutritional therapy, low BMI and low serum albumin concentrations have all previously been associated with mortality at 30 days. [10,12] However, albumin is a negative acute phase reactant, and declining serum concentrations may be more reflective of the magnitude of the systemic inflammatory response rather than nutritional status.…”

Section: Introductionmentioning

confidence: 99%

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Palliative stenting for oesophagogastric cancer: tumour and host factors and prognosis

Park

Woodley

Glen

2018

BMJ Support Palliat Care

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ObjectivesPalliative self-expandable metallic stent (SEMS) insertion is common in patients not suitable for resection of oesophago-gastric (OG) cancer. Factors which may determine survival however are not clear. The present study examined the relationship between tumour and host factors, including the systemic inflammatory response, and survival of patients undergoing palliative SEMS insertion. MethodsPatients with a diagnosis of OG cancer who were considered suitable for palliative SEMS only without systemic therapy were identified. Patient characteristics including Eastern Cooperative Oncology Group performance status, radiological stage and modified Glasgow were associated with shorter survival. The combination of performance status and mGPS stratified three-month survival of patients without metastatic disease from 88% to 20% (P<0.001) and patients with metastases from 43% to 6% (P=0.059). Similar results were 3 observed when analysis was restricted to patients with oesophageal and junctional cancer (M0: 83% to 20%, P=0.008; M1: 33% to 8%, P=0.082). ConclusionPerformance status, metastatic disease and mGPS are independent predictors of survival in patients with OG cancer undergoing palliative SEMS insertion. These routinely available markers provide a rational system on which to base decisions regarding prognosis and treatment.

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“…[9] Such characteristics are routinely collected at time of diagnosis and staging, and given their well-established value, provide a logical backbone on which to base prognosis.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Palliative stenting for oesophagogastric cancer: tumour and host factors and prognosis

Park

Woodley

Glen

2018

BMJ Support Palliat Care

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“…Although brachytherapy was found to be preferable, there are studies (such as Refs. [27,28]) suggesting the stent placement may play an important role for the palliation of disease. In that case, the prognostic models were used as evidence-based tools in decision making.…”

Section: Brachytherapy Of Esophageal Cancermentioning

confidence: 99%

Radiation Therapy for Esophageal Cancer

Buzurović¹,

Daróczi²,

O’Farrell³

et al. 2017

Esophageal Abnormalities

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Esophageal cancer develops in the mucosa of the esophagus and spreads toward the muscle layer. The nonsurgical treatment for localized, deeply invasive esophageal cancer has been external beam radiation therapy (EBRT) and concurrent chemotherapy. Recently, intraluminal brachytherapy showed a strong potential for the improvement of the therapeutic ratio. It was found that the fractionated high dose rate (HDR) brachytherapy ofered beneicial palliation for a longer period of time with more durable symptom control. A similar was concluded for advanced unresectable esophageal cancer in previously irradiated patients. HDR brachytherapy may be a useful salvage treatment option for inoperable patients diagnosed with local esophageal cancer. Although beter local control can be achieved with higher brachytherapy dose, this increases the risk of acute morbidity and late morbidity, especially in the seting of recurrence cancer. It was found that the moderate dose of EBRT and HDR brachytherapy could give a beter local response than EBRT alone.

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“…Current stent technology guided delivery device to pass a compressed and constrained mesh stent across the area to be treated. Metal stents have become popular for the palliation of patients with malignant esophageal obstruction, especially patients with a poor prognosis [8][9][10][11]. At present more than 100 types of stent are available on the market [12], ified in accordance with their clinical use (vascular or nonvascular, coronary or peripheral).…”

Section: Stent Design Overviewmentioning

confidence: 99%

Influence of Negative Poisson′s Ratio on Stent Applications

Bhullar¹

2013

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Abstract:Stents are usually defined as small tubular structures that are inserted into the diseased region which provide mechanical support of damaged artery or some other hollow organ to restore lumen and blood flow conditions in arteries. Recently developed stents may accumulate functions; for example, they can be used for drug delivery or for treatment of bleeding esophageal varices. Further clinical failures such as crushing, removing, restenosis are some of the most serious reasons for continuing stent improvements. Therefore, our research study has the design and manufacture of an auxetic structure with enhanced mechanical properties through the tailored negative Poisson's ratio, and its configuration as an auxetic stent to be used for example in the palliative treatment of esophageal cancer and for the prevention of dysphagia as the main objective. Background: The use of stents for esophageal diseases has evolved greatly over the past 30 years. Esophageal cancer is the growth of cancer cells in the esophagus tube which usually originates in the inner layers of the lining of the esophagus and grows outward. In time, the tumor can obstruct the passage of food and liquid, making swallowing painful and difficult. Since most patients are not diagnosed until the late stages of the disease, esophageal cancer is associated with poor quality of life and low survival rates. Method: This research study is organized in three parts devoted to fabrication of auxetic structure and stent samples, experimental testing and discussion of results. For this purpose a model of an auxetic rotating-square geometry with a circular hole structure is developed by laser cutting apolyurethane sheet. The auxeticoesophageal stent was made by folding and gluing the auxetic sheet (with rigid squares and circular holes) into a cylindrical shape. Combined videoextensometry with compressive and tensile testing are employed to determine the deformation response of the auxetic sheet and stent to obtain stress-strain curves and estimation of Poisson's ratio.Conclusions: The stenting outcomes are improved through mechanical design with tailored negative Poisson's ratio through cell geometry of the esophagus stent. Theauxetic stent geometry of rotating squares with circular holes will be lighter in weight; reduces obstruction and food impaction because of its unique deformation mechanism; and can reduces migration of the implant stent by embedding inside the tissue.

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Stent placement or brachytherapy for palliation of dysphagia from esophageal cancer: a prognostic model to guide treatment selection

Cited by 87 publications

References 37 publications

Palliative stenting for oesophagogastric cancer: tumour and host factors and prognosis

Palliative stenting for oesophagogastric cancer: tumour and host factors and prognosis

Radiation Therapy for Esophageal Cancer

Influence of Negative Poisson′s Ratio on Stent Applications

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