title: Palliative therapy for esophageal cancer: laser therapy alone is associated with a better functional outcome.
abstract: The aim of our study was to compare functional outcome and survival in patients who underwent laser therapy (LT) or laser therapy and esophageal stenting (LTES) to palliate inoperable esophageal cancer. Two hundred and twenty-seven consecutive patients who had endoscopic palliation for esophageal cancer were enrolled in this retrospective study. One hundred and sixty-four underwent LT alone and 63 had LTES. A dysphagia score was adopted (0: absolute dysphagia; 1: liquid diet; 2: semisolid diet; 3: free diet). Survival analysis and non parametric statistics were performed. Patients in the LTES group reported a significantly worse dysphagia score than LT patients (p < 0.01). LTES patients more frequently reported difficulty swallowing than LT patients (p < 0.01). No difference between LTES and LT groups was observed in terms of overall survival. Only radiotherapy resulted in a significant predictor of better survival (p = 0.007). Despite a similar survival, LTES is a predictor of a worse functional palliation than LT alone. Radiotherapy was associated with better survival in patients treated with LT. Therefore, these data seem to suggest that a combination of endoscopic LT and external radiotherapy may yield the best results in palliative care of advanced esophageal cancer.
authors: Surgical Endoscopy Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, via Giustinani 2, 35128, Padua, Italy, annapozza@yahoo.it.
authors: Anna
authors: A
authors: Pozza
authors: Francesca R
authors: FR
authors: Erroi
authors: Marco
authors: M
authors: Scarpa
authors: Lino
authors: L
authors: Polese
authors: Luigi
authors: L
authors: Rampazzo
authors: Lorenzo
authors: L
authors: Norberto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
references: Gastrointest Endosc. 1998 Oct;48(4):376-82
references: 9786109
references: Gut. 1982 Dec;23(12):1060-7
references: 6184269
references: World J Gastroenterol. 2011 Nov 14;17(42):4660-74
references: 22180708
references: Gastrointest Endosc. 1998 Oct;48(4):383-8
references: 9786110
references: CA Cancer J Clin. 2003 Jan-Feb;53(1):5-26
references: 12568441
references: Radiology. 1997 Feb;202(2):344-8
references: 9015054
references: Eur J Surg Oncol. 2002 Nov;28(7):711-5
references: 12431467
references: Cochrane Database Syst Rev. 2011 Feb 16;(2):CD005048
references: 21328271
references: Gut. 2002 Feb;50(2):224-7
references: 11788564
references: Gut. 1996 Jun;38(6):803-5
references: 8984013
references: Gut. 1997 Mar;40(3):362-9
references: 9135526
references: Gastrointest Endosc. 2001 Nov;54(5):549-57
references: 11677469
references: Ann Surg Oncol. 2008 Sep;15(9):2372-9
references: 18626719
references: World J Surg. 2004 Feb;28(2):124-9
references: 14708057
references: Arch Surg. 2009 Mar;144(3):247-54; discussion 254
references: 19289664
references: Gut. 1996 Nov;39(5):726-31
references: 9014774
references: World J Gastroenterol. 2012 Mar 28;18(12):1404-9
references: 22493556
references: World J Gastroenterol. 2011 Jan 14;17(2):144-50
references: 21245986
references: Cancer. 2001 Jun 1;91(11):2165-74
references: 11391598
references: Gastrointest Endosc. 1991 Jul-Aug;37(4):433-40
references: 1717341