Characteristics of esophagorespiratory fistulas resulting from esophageal cancers: a single-center study on 243 cases in a 20-year period.
BACKGROUND
Esophagorespiratory fistulas are serious complications of esophageal tumors. The main goal of this study was to reveal their characteristics.


METHODS
In the period between 1984 and 2004, 243 fistulas were diagnosed among the 1993 patients with esophageal cancer. Comparing the characteristic data of patients with and without fistula (demographics, symptoms, duration time of symptoms, morphologic features, histology, metastases, staging), multivariance analysis showed significant differences (P < 0.05). Patients with fistula were divided into two additional groups (I, n = 82; II, n = 161 cases) with cluster analysis. The difference between these two groups was also significant.


RESULTS
It was possible to perform a palliative endoscopic intubation in 176 cases, while 62 patients could be treated only supportively. The average survival was 3.4 and 1.2 months, respectively. Fistula was a late complication of tumor in two thirds (66.3%) of the cases, while in 33.7% it was diagnosed in younger patients at the early stage of the disease, with a more aggressive, less differentiated histology. In these patients the weight loss, the grade of dysphagia, and the size of the tumor were smaller, the possibilities of treatment were fewer, and survival time was shorter (2.1 vs. 3.1 months).


CONCLUSIONS
These tumors seem to be specific forms of esophageal cancers. For a better quality of life and longer survival time for these patients, there should be earlier diagnosis and endoscopic intubation as the best palliative treatment should be performed.
Balazs
Akos
A
1st Department of Surgery, Faculty of Medicine, Semmelweis University, Ulloi u. 78, Budapest 1082, Hungary. balazsdr@gmail.com
Galambos
Zoltan
Z
Kupcsulik
Peter K
PK
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D003680:Deglutition Disorders / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014138:Tracheoesophageal Fistula / Q000453:epidemiology* / Q000628:therapy; D015431:Weight Loss