title: Outcome and risk factors assessment for adverse events in advanced esophageal cancer patients after self-expanding metal stents placement.
abstract: Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. Cross-sectional study of patients with advanced esophageal cancer referred for SEMS placement, during a period of 3 years. Ninety-seven patients with advanced esophageal cancer placed SEMS. Adverse events were more common when tumors were located at the level of the distal esophagus/cardia (47% vs 23%, P = 0.011, OR 3.1), with statistical significance being kept in the multivariate analysis (OR 3.1, P = 0.018). Time until adverse events was lower in the tumors located at the level of the distal esophagus/cardia (P = 0.036). Survival was higher in patients who placed SEMS with curative intent (327 days [126-528] vs. 119 days [91-147], P = 0.002) and in patients submitted subsequently to surgery compared with those who did just chemo/radiotherapy or who did not do further treatment (563 days [378-748] vs. 154 days [133-175] vs. 46 days [20-72], P < 0.001). Subsequent treatment kept statistical significance in the multivariate analysis (HR 3.4, P < 0.001). SEMS allow palliation of dysphagia in advanced esophageal cancer and are associated with an increased out-of-hospital survival, as long as there are conditions for further treatments. Tumors located at the level of the distal esophagus/cardia are associated with a greater number of adverse events, which also occur earlier.
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: E
authors.initials: E
authors.lastname: Rodrigues-Pinto
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Pereira
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Coelho
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Andrade
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Ribeiro
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Lopes
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Moutinho-Ribeiro
authors.affiliation: Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Macedo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D000069322:Self Expandable Metallic Stents / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
keywords: adverse events; esophageal cancer; self-expanding metal stents; survival