Prior chemoradiotherapy is associated with a higher life-threatening complication rate after palliative insertion of metal stents in patients with oesophageal cancer.
BACKGROUND
Self-expanding metal stents are used routinely to palliate dysphagia due to oesophageal cancer.


OBJECTIVE
To compare the frequency of life-threatening complications after self-expanding metal stent insertion, depending on whether patients received prior chemoradiotherapy or no treatment.


METHODS
During 7 years, 116 consecutive patients were treated at a single centre in a palliative intent by insertion of self-expanding metal stent for dysphagia due to an oesophageal cancer. Patients were retrospectively separated into two groups: patients with chemoradiotherapy before self-expanding metal stent insertion (group 1, n = 56) and patients with no treatment before or after self-expanding metal stent insertion (group 2, n = 60). Life-threatening complications were compared and predictive risk factors of postprocedure complications were identified.


RESULTS
Median dysphagia was significantly improved during the first month (grade 3 to grade 1 in the two groups). Early and late major complications occurred more frequently in group 1 (23.2% vs. 3.3%; P < 0.002 and 21.6% vs. 5.1%; P < 0.02 respectively). Prior chemoradiotherapy was the only independent predictive factor of postprocedure major complications, with an odds ratio of 5.59 (CI 95% 1.7-18.1).


CONCLUSIONS
Life-threatening complications after palliative self-expanding metal stent placement seem to occur more frequently in patients with prior chemoradiotherapy. Prevention of these severe complications should be considered before stenting.
Lecleire
S
S
ADEN-EA3234/IFRMP23 Research Group, Department of Hepato-Gastroenterology and Nutrition, Rouen University Hospital Charles-Nicolle, France. stephane.lecleire@chu-rouen.fr
Di Fiore
F
F
Ben-Soussan
E
E
Antonietti
M
M
Hellot
M-F
MF
Paillot
B
B
Lerebours
E
E
Ducrotté
P
P
Michel
P
P
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000379:methods; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents
D000970:Antineoplastic Agents