title: Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula.
abstract: BACKGROUND
  Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer.
  
  
  METHODS
  In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study.
  
  
  RESULTS
  From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95% confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95% CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95% CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95% CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95% CI, 0.03-0.59) remained as significant factors that impacted survival.
  
  
  CONCLUSIONS
  Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Chung
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Chou
authors.forename: Hao-Cheng
authors.initials: HC
authors.lastname: Chen
authors.forename: Chih-Hsi
authors.initials: CH
authors.lastname: Kuo
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Lin
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000628:therapy*