[Stenting for superior vena cava obstruction associated with lung cancer: monocentric study].
BACKGROUND
Superior vena cava obstruction is an urgent complication of lung cancer. Superior vena cava stent insertion can be considered to provide rapid relief of the symptoms.


METHODS
To estimate the efficiency and the complications of this procedure, we retrospectively analyzed 41 consecutive patients treated during the last 5 years by self-expanding nitinol stent insertion for superior vena cava obstruction due to lung cancer. It was combined with anticoagulation and corticosteroids.


RESULTS
41 patients benefited from this treatment (30 men and 11 women) with an average age of 59 years. Etiologies of the vena cava obstruction were: small cell carcinoma (11), adenocarcinoma (8), squamous cell carcinoma (9), large cell carcinoma (9) and others (4). All patients were symptomatic. The average period between the onset of symptoms and the vascular stenting was 14 days. Specific treatment was chemotherapy (18 patients), radiotherapy (1 patient), or both (14 patients), and no specific treatment for 6 patients. The procedure consisted of the insertion of 1 (73%) or 2 (27%) stents, with an average length and caliber of 7.5 cm and 14 mm respectively. No major complication was reported in short and long-term follow up. Symptomatic improvement was observed for all the patients within 48 hours. Median survival after the stenting was of 6.7 months.


CONCLUSIONS
In our study, vascular stenting for malignant superior cava vena obstruction allows a rapid improvement of the symptoms with very few complications, suggesting a possible role as first line treatment for chemo or radio-resistant tumours.
Pierre
M-C
MC
Service de Pneumologie-allergologie, Clinique des Voies Respiratoires, Hôpital Larrey, Toulouse, France.
Chabbert
V
V
Lozano
S
S
Bigay-Game
L
L
Lévêque
N
N
Desloques
L
L
Otal
P
P
Rousseau
H
H
Didier
A
A
Mazières
J
J
D000230:Adenocarcinoma / Q000150:complications*; D000328:Adult; D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications*; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000150:complications*; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000209:etiology / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D013997:Time Factors