title: Comparison of temporary and permanent stent placement with concurrent radiation therapy in patients with esophageal carcinoma.
abstract: OBJECTIVE
  To assess the clinical effectiveness of temporary metallic stent placement with concurrent radiation therapy in patients with esophageal carcinoma by comparing it with permanent stent placement with concurrent radiation therapy.
  
  
  METHODS
  Covered retrievable expandable nitinol stents were placed in 47 patients with esophageal carcinoma 1 week before starting radiation therapy; the stents were electively removed 4 weeks after placement in 24 patients (group A), while not electively removed in the other 23 patients (group B). In cases of complications, the stents were also removed from patients in groups A and B. The dysphagia score, complications (severe pain, granulation tissue formation, stent migration, esophagorespiratory fistula, and hematemesis), tumor overgrowth/regrowth, reintervention rates, and dysphagia-progression-free and overall survival rates were compared in the two groups.
  
  
  RESULTS
  Stent placement or removal was technically successful and well tolerated in all patients. The dysphagia score was significantly improved in both groups after stent placement (P < .01). Each of the stent-related complications was less in group A than in group B but there was no significant difference. However, the total number of patients with one or more than one complications and who needed related reinterventions was significantly less in group A than in group B (P = .042 and .030, respectively). Tumor overgrowth/regrowth and the total number of patients who required related reinterventions was not significantly different (P = 1.00 and .517, respectively). Dysphagia-progression-free and overall survival rates were significantly longer in group A than in group B (P = .005 and .001, respectively).
  
  
  CONCLUSIONS
  Temporary placement of a covered retrievable expandable metallic stent with concurrent radiation therapy for patients with esophageal carcinoma is beneficial for reducing complications and related reinterventions and for increasing resultant survival rates compared with permanent esophageal stent placement.
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Seung-Il
authors.initials: SI
authors.lastname: Park
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Han
authors.forename: Weechang
authors.initials: W
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000532:radiotherapy*; D016022:Case-Control Studies; D020099:Coated Materials, Biocompatible; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000532:radiotherapy*; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011140:Polyurethanes; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; D011140:Polyurethanes; C013616:nitinol