Endoscopic self-expandable metallic stent placement in malignant pyloric or duodenal obstruction: does chemotherapy affect stent patency?
OBJECTIVE
Self-expandable metallic stents (SEMS) have been used for palliation in patients with malignant gastroduodenal obstructions. We evaluated clinical outcomes after SEMS placement and identified prognostic factors of SEMS patency, including chemotherapy.


METHODS
A review of records of 85 patients with unresectable gastric or pancreatic cancer who underwent endoscopic SEMS insertion for gastroduodenal obstructions at Seoul National University Bundang Hospital.


RESULTS
From August 2003 to October 2009, 85 patients with gastroduodenal obstruction were managed with endoscopic SEMS placement. Technical success was achieved in 82 patients (96%) and clinical success in 68 patients (80%). Of 49 patients who had clinical success, 19 underwent chemotherapy (chemoTx group), and 30 patients did not (non-chemoTx group). Cumulative SEMS patency in the 49 patients who achieved clinical success were 84, 54 and 41% at 2, 3 and 6 months, respectively. By univariate and multivariate analysis, there was no statistical difference in the SEMS patency between the two groups (cumulative SEMS patency rate: 95 vs 73% at 2 months, 15 vs 63% at 3 months, 40 vs 42% at 6 months, respectively, P < 0.793).


CONCLUSIONS
Chemotherapy does not improve SEMS patency in patients with malignant gastroduodenal obstruction caused by unresectable gastric or pancreatic cancer.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Byung Hyo
BH
Cha
Sang Hyub
SH
Lee
Jang Eun
JE
Kim
Ji Youn
JY
Yoo
Young Soo
YS
Park
Jin-Wook
JW
Kim
Sook-Hyang
SH
Jeong
Nayoung
N
Kim
Dong Ho
DH
Lee
Jin-Hyeok
JH
Hwang
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004380:Duodenal Obstruction / Q000209:etiology / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D011708:Pylorus / Q000473:pathology*; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications* / Q000628:therapy; D000093542:Gemcitabine
D003841:Deoxycytidine; D002945:Cisplatin; D005472:Fluorouracil; D000093542:Gemcitabine