Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPJOSINO, Iatagan R.MARTINS, Bruno C.MACHADO, Andressa A.LIMA, Gustavo R. de A.CORDERO, Martin A. C.POMBO, Amanda A. M.SALLUM, Rubens A. A.JR, Ulysses RibeiroBARON, Todd H.MALUF-FILHO, Fauze2024-04-052024-04-052023CLINICAL ENDOSCOPY, v.56, n.6, p.761-768, 20232234-2400https://observatorio.fm.usp.br/handle/OPI/58883Background/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.engopenAccessEsophageal fistulaEsophageal neoplasmsSelf-expandable metallic stentsmalignant dysphagiaprior radiationadverse eventscomplicationsplacementchemotherapypalliationsurvivalradiotherapyexperiencearticleCopyright KOREAN SOC GASTROINTESTINAL ENDOSCOPY10.5946/ce.2022.297Gastroenterology & Hepatology2234-2443