The use of self-expanding stents in esophageal and gastroesophageal junction cancer palliation: a meta-analysis and meta-regression analysis of outcomes.
BACKGROUND
The objective of this study was to examine the impact of self-expanding stents versus locoregional treatment modalities in the setting of esophageal cancer palliation.


METHODS
The present meta-analysis pooled the effects of outcomes of 1,027 patients enrolled in 16 randomized controlled trials.


RESULTS
The meta-analysis revealed an advantage to the use of stents compared to locoregional modality treatments with respect to the number of patients requiring reinterventions, although the latter treatment arm had a higher 1-year survival. No difference was observed between the use of the antireflux stents and conventional stents in relieving reflux. Previous chemoradiotherapy had no impact on complications, procedural deaths, and overall patient survival. Differences in outcomes among stents were minimal.


CONCLUSIONS
Conventional self-expanding stents and anti-reflux stents are equally effective. Although the risk difference for 1-year survival favoured locoregional palliative treatment modalities, the latter were associated with a higher number of patients requiring reintervention.
Sgourakis
George
G
2nd Surgical Department and Surgical Oncology Unit, Korgialenio-Benakio Red Cross Hospital, 11 Mantzarou Str., Neo Psychiko, Athens, Greece. ggsgourakis@yahoo.gr
Gockel
Ines
I
Radtke
Arnold
A
Dedemadi
Georgia
G
Goumas
Konstantinos
K
Mylona
Sofia
S
Lang
Hauke
H
Tsiamis
Achilleas
A
Karaliotas
Constantine
C
D001918:Brachytherapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D004943:Esophagogastric Junction; D006801:Humans; D016017:Odds Ratio; D010166:Palliative Care; D017594:Publication Bias; D012372:ROC Curve; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D016896:Treatment Outcome