title: Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status.
abstract: Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered.
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Mão-de-Ferro
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Serrano
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Ferreira
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Rosa
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Lage
authors.affiliation: Department of Nutrition, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: D P
authors.initials: DP
authors.lastname: Alexandre
authors.affiliation: Department of Oncology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Freire
authors.affiliation: Department of Radiation Oncology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Mirones
authors.affiliation: Department of Surgery, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Casaca
authors.affiliation: Department of Surgery, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Bettencourt
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal.
authors.forename: A D
authors.initials: AD
authors.lastname: Pereira
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D015607:Stents