Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy

Abstract Background Self‐expandable metallic stent (SEMS) placement is useful for patients with poor oral intake caused by esophageal stricture attributable to malignancy. In this study, we examined the usefulness of esophageal SEMS placement as a palliative treatment and evaluated the prognostic fa...

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Main Authors: Yasuki Hatayama, Hideaki Ishigami, Hidehiro Kamezaki, Daisuke Murakami, Yukiko Shima, Kentaro Ishikawa, Harutoshi Sugiyama, Takayoshi Nishino, Makoto Arai
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.70120
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author Yasuki Hatayama
Hideaki Ishigami
Hidehiro Kamezaki
Daisuke Murakami
Yukiko Shima
Kentaro Ishikawa
Harutoshi Sugiyama
Takayoshi Nishino
Makoto Arai
author_facet Yasuki Hatayama
Hideaki Ishigami
Hidehiro Kamezaki
Daisuke Murakami
Yukiko Shima
Kentaro Ishikawa
Harutoshi Sugiyama
Takayoshi Nishino
Makoto Arai
author_sort Yasuki Hatayama
collection DOAJ
description Abstract Background Self‐expandable metallic stent (SEMS) placement is useful for patients with poor oral intake caused by esophageal stricture attributable to malignancy. In this study, we examined the usefulness of esophageal SEMS placement as a palliative treatment and evaluated the prognostic factors. Materials and methods Patients who underwent esophageal SEMS placement at three regional base hospitals from December 2007 to June 2023 were included in the study. Results Of 73 patients, 57 patients who underwent palliative SEMS placement were evaluated after excluding 16 patients in whom postoperative treatment was possible after SEMS placement. Median survival after SEMS placement was 67 days (mean, 96 ± 16 days). Univariate analysis identified age (≤78 years vs. >78 years), performance status (3 or 4 vs. 1 or 2), the cancer location (other sites vs. gastrointestinal cancer), the resumption of oral intake (failure vs. success), and clinical stage (IVA/IVB vs. III) as prognostic factors after SEMS placement. On multivariate analysis, performance status 3 or 4 (odds ratio [OR] = 2.87, 95% confidence interval [CI] = 1.28–6.45), cancers other than gastrointestinal cancer (OR = 3.75, 95% CI = 1.14–12.3), and failure to resume oral intake (OR = 21.3, 95% CI = 3.40–133.0) were significantly associated with poor prognosis. Conclusions Palliative treatment with SEMS placement was safe, and a high percentage of patients resumed food intake. An inability to resume food intake, poor performance status, and cancer outside the gastrointestinal tract were poor prognostic factors.
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spelling doaj-art-b5f4dcbc78274eb39287ec1d5ced0d7b2025-08-20T02:18:56ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70120Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancyYasuki Hatayama0Hideaki Ishigami1Hidehiro Kamezaki2Daisuke Murakami3Yukiko Shima4Kentaro Ishikawa5Harutoshi Sugiyama6Takayoshi Nishino7Makoto Arai8Department of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Chiba Rosai Hospital Chiba JapanDepartment of Gastroenterology Eastern Chiba Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanDepartment of Gastroenterology Tokyo Women's Medical University Yachiyo Medical Center Chiba JapanAbstract Background Self‐expandable metallic stent (SEMS) placement is useful for patients with poor oral intake caused by esophageal stricture attributable to malignancy. In this study, we examined the usefulness of esophageal SEMS placement as a palliative treatment and evaluated the prognostic factors. Materials and methods Patients who underwent esophageal SEMS placement at three regional base hospitals from December 2007 to June 2023 were included in the study. Results Of 73 patients, 57 patients who underwent palliative SEMS placement were evaluated after excluding 16 patients in whom postoperative treatment was possible after SEMS placement. Median survival after SEMS placement was 67 days (mean, 96 ± 16 days). Univariate analysis identified age (≤78 years vs. >78 years), performance status (3 or 4 vs. 1 or 2), the cancer location (other sites vs. gastrointestinal cancer), the resumption of oral intake (failure vs. success), and clinical stage (IVA/IVB vs. III) as prognostic factors after SEMS placement. On multivariate analysis, performance status 3 or 4 (odds ratio [OR] = 2.87, 95% confidence interval [CI] = 1.28–6.45), cancers other than gastrointestinal cancer (OR = 3.75, 95% CI = 1.14–12.3), and failure to resume oral intake (OR = 21.3, 95% CI = 3.40–133.0) were significantly associated with poor prognosis. Conclusions Palliative treatment with SEMS placement was safe, and a high percentage of patients resumed food intake. An inability to resume food intake, poor performance status, and cancer outside the gastrointestinal tract were poor prognostic factors.https://doi.org/10.1002/deo2.70120canceresophageal stentpalliative careprognosissurvival
spellingShingle Yasuki Hatayama
Hideaki Ishigami
Hidehiro Kamezaki
Daisuke Murakami
Yukiko Shima
Kentaro Ishikawa
Harutoshi Sugiyama
Takayoshi Nishino
Makoto Arai
Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
DEN Open
cancer
esophageal stent
palliative care
prognosis
survival
title Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
title_full Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
title_fullStr Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
title_full_unstemmed Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
title_short Efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
title_sort efficacy of palliative stenting in patients with esophageal obstruction attributable to malignancy
topic cancer
esophageal stent
palliative care
prognosis
survival
url https://doi.org/10.1002/deo2.70120
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