Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer

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Citações na Scopus
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Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Dimensions
Título da Revista
ISSN da Revista
Título do Volume
Editora
KOREAN SOC GASTROINTESTINAL ENDOSCOPY
Autores
LIMA, Gustavo R. de A.
BARON, Todd H.
Citação
CLINICAL ENDOSCOPY, v.56, n.6, p.761-768, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMSERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de Sao Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01- 4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.
Palavras-chave
Esophageal fistula, Esophageal neoplasms, Self-expandable metallic stents
URI
https://observatorio.fm.usp.br/handle/OPI/58883
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT