title: Temporary stent placement with concurrent chemoradiation therapy in patients with unresectable oesophageal carcinoma: is there an optimal time for stent removal?
abstract: OBJECTIVE
  To investigate the influence of the timing of stent removal on the outcome of temporary stent placement with concurrent chemoradiation therapy in patients with unresectable oesophageal carcinoma.
  
  
  METHODS
  Retrospective analysis was performed on 52 patients undergoing temporary stent placement. Stents were electively removed within 4 weeks in 15 patients (group A), 4-6 weeks in 17 patients (group B) and after 6 weeks in 20 patients (group C). Recurrent symptoms after stent removal, dysphagia score and overall survival periods were compared among the groups.
  
  
  RESULTS
  Stent placement and removal were technically successful in all patients. The dysphagia score was significantly improved in all groups (P < 0.001). In 19 patients (36 %), recurrent symptoms occurred 15-441 days after stent removal. In group A, recurrent obstruction was significantly higher than in groups B (P = 0.049) and C (P = 0.019). Incidence of oesophago-respiratory fistulas in group C was significantly higher than in group A (P = 0.027). There was no significant difference in survival periods.
  
  
  CONCLUSIONS
  The ideal time for stent removal likely falls between 4 and 6 weeks following the start of palliative CCRT allowing the temporary stents to relieve dysphagia effectively in patients with unresectable oesophageal carcinoma.
  
  
  CONCLUSIONS
  • Stents are usually required for unresectable oesophageal carcinoma • Optimal timing of stent removal is 4-6 weeks after starting palliative CCRT. • Early stent removal (<4 weeks) is associated with higher recurrence rates. • Delayed stent removal (>6 weeks) is associated with greater oesophago-respiratory fistula development.
authors: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap 2-dong, Songpa-gu, Seoul, Republic of Korea.
authors: Jung-Hoon
authors: JH
authors: Park
authors: Ho-Young
authors: HY
authors: Song
authors: Ju Yang
authors: JY
authors: Park
authors: Jin Hyoung
authors: JH
authors: Kim
authors: Yong Hee
authors: YH
authors: Kim
authors: Jong-Hoon
authors: JH
authors: Kim
authors: Sung-Bae
authors: SB
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000628:therapy*; D020878:Device Removal / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D004940:Esophageal Stenosis / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals / Q000737:chemistry; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D011138:Polytetrafluoroethylene / Q000737:chemistry; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals; D011138:Polytetrafluoroethylene