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


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.
Sundelöf
Martin
M
Division of Surgery, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. martin.sundelof@ds.se
Ringby
Daniel
D
Stockeld
Dag
D
Granström
Lars
L
Jonas
Eduard
E
Freedman
Jacob
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000628:therapy; D004947:Esophagus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents / Q000009:adverse effects