Palliative treatment of malignant dysphagia with self-expanding metal stents: A 12-year experience

Abstract

Objective. The incidence of oesophageal cancer is increasing but the prognosis is still very poor. Around 50% of patients have advanced disease when diagnosed. Stenting using expandable metal stents is primarily aimed at palliation. The purpose of this study was to evaluate factors influencing morbidity, procedure-related mortality and symptom relief for dysphagia in patients with unresectable oesophageal cancer treated with self-expanding metal stents. Material and methods. We conducted a retrospective observational clinical study of consecutive patients treated with self-expanding metal stents in the Department of Surgery, Danderyd Hospital, Sweden, between January 1993 and May 2005. Results. One hundred and seventy-four stents were placed in 149 patients. The procedure-related mortality was 3% and the complication rate 26%. Pre- and post-treatment dysphagia could be evaluated in 139 stent placements, and showed significant improvement of dysphagia symptoms in 70% of subjects (p<0.0001). Tumour length, tumour location, histology, age, gender or prior dilatation did not affect the outcome regarding procedure-related morbidity or symptom relief. Conclusions. Palliation of malignant dysphagia with self-expanding metal stents is safe and confers almost immediate improvement of dysphagia in the majority of patients. Tumour-related and demographic factors do not seem to influence the outcome.

• Complications
• demographic factors
• dysphagia
• oesophageal cancer
• palliation
• stent
• tumour-related factors