title: Endoscopic stent placement for cancer of the lower esophagus and gastric cardia.
abstract: We reviewed our results of using stents for palliation of cancer of the lower third of the esophagus and gastric cardia. During a 14-year period, 76 patients with either lower third esophageal cancer (n = 43) or cancer of the gastric cardia (n = 33) received stents for palliation of malignant dysphagia. Successful endoscopic placement was initially achieved in all patients, with 71 patients available for follow-up. Of these, 40 (56%) were subsequently able to eat solid or semi-solid food, 25 (35%) could swallow only liquids, and 6 (8%) were unimproved. The combined early and late complication rate totalled 22%. Early complications included perforation (n = 3) and stent migration (n = 4); late complications consisted of dislodgment (n = 6), obstruction by tumor (n = 2), and severe esophagitis (n = 1). There were no procedure-related deaths, but survival at 1 year was estimated to be only 1.5%, with a median survival of 2.5 months after stent insertion. The endoscopic placement of prosthetic stents for cancer of the distal esophagus and gastric cardia entails a higher complication rate, less successful palliation, and shorter survival time compared to similar treatment for more proximal esophageal cancer.
authors.affiliation: Department of Diagnostic and Surgical Endoscopy, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Spinelli
authors.forename: F G
authors.initials: FG
authors.lastname: Cerrai
authors.forename: M
authors.initials: M
authors.lastname: Ciuffi
authors.forename: O
authors.initials: O
authors.lastname: Ignomirelli
authors.forename: E
authors.initials: E
authors.lastname: Meroni
authors.forename: P
authors.initials: P
authors.lastname: Pizzetti
mesh_terms: D000368:Aged; D002299:Cardia; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000401:mortality; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care; D015607:Stents / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000150:complications* / Q000401:mortality; D015996:Survival Rate