Comparison of temporary and permanent stent placement with concurrent radiation therapy in patients with esophageal carcinoma.
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.
Shin
Ji Hoon
JH
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Song
Ho-Young
HY
Kim
Jong Hoon
JH
Kim
Sung-Bae
SB
Lee
Gin Hyug
GH
Park
Seung-Il
SI
Han
Young-Min
YM
Kang
Weechang
W
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
D000497:Alloys; D020099:Coated Materials, Biocompatible; D011140:Polyurethanes; C013616:nitinol