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https://observatorio.fm.usp.br/handle/OPI/21460
Title: | Adverse events of self-expandable esophageal metallic stents in patients with long-term survival from advanced malignant disease |
Authors: | MEDEIROS, Vitor Sousa; MARTINS, Bruno Costa; LENZ, Luciano; RIBEIRO, Maria Sylvia Ierardi; PAULO, Gustavo Andrade de; LIMA, Marcelo Simas; SAFATLE-RIBEIRO, Adriana Vaz; KAWAGUTI, Fabio Shiguehissa; PENNACCHI, Caterina; GEIGER, Sebastian N.; BASTOS, Victor R.; RIBEIRO-JUNIOR, Ulysses; SALLUM, Rubens A.; MALUF-FILHO, Fauze |
Citation: | GASTROINTESTINAL ENDOSCOPY, v.86, n.2, p.299-306, 2017 |
Abstract: | Background and Aims: Self-expandable metallic stents are considered the best palliative treatment of dysphagia for patients with advanced esophageal cancer. Adverse events (AEs) are a major concern, especially in patients with better prognosis and longer survival. The present study aimed to evaluate the AEs of patients who survived longer than 6 months with esophageal stents in place. Methods: This is a retrospective analysis of a prospectively collected database including all patients submitted to esophageal stent placement for the palliation of malignant diseases during the period from February 2009 to February 2014 at a tertiary care academic center who had stents longer than 6 months. Results: Sixty-three patients were included. Mean follow-up was 10.7 months. Clinical success was achieved in all patients, and the median stent patency was 7.1 months. AEs occurred in 40 patients (63.5%), totaling 62 AEs (mean, 1.5 AEs per patient). Endoscopic management of AEs was successful in 84.5% of cases, with a mean of 1.6 reinterventions per patient. The univariate analysis revealed that performance status, age, and post-stent radiotherapy presented a trend to higher risk of AEs. The multivariate analysis revealed that only performance status was associated with AEs (P = .025; hazard ratio, 4.1). Conclusions: AEs are common in patients with long-term esophageal stenting for malignancy. However, AEs were not related to higher mortality rate, and most AEs could be successfully managed by endoscopy. Only performance status was a risk factor for AEs. Our data suggest that metallic stenting is a valid option for the treatment of malignant esophageal conditions, even when survival longer than 6 months is expected. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MGT Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - LIM/37 Artigos e Materiais de Revistas Científicas - ODS/03 |
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