TY - JOUR
T1 - Esophageal prothesis for neoplastic stenosis. A prognostic study of 77 cases
AU - Chavy, A. L.
AU - Rougier, PH M.
AU - Pieddeloup, CH
AU - Kac, J.
AU - Laplanche, A. C.
AU - Elias, D. M.
AU - Ducreux, M. P.
AU - Zummer‐Rubinstein, K.
AU - Zimmermann, P. A.
AU - Charbit, M. A.
AU - Crespon, B. M.
PY - 1986/1/1
Y1 - 1986/1/1
N2 - Esophageal prothesis (EP) is a palliative treatment for inoperable neoplastic stenosis. Ninety‐one patients were candidates for EP placement between 1978 and 1983. EP placement was successful in 77 patients. Of these: 85% had primary esophageal cancer; 15% had bronchial or mediastinal carcinoma; 83% had stenosis in the middle third. Dysphagia was the main symptom in 84%, and tracheoesophageal fistulae in 16%. The observed median survival was 3.2 months ± 1.9 (2 standard deviations [SD]), and the survival rate at 1 year was 7%. With the single‐factor analysis method, not one of 12 factors presented any significance (age, sex, general status, anterior treatment, lesion site, endoscopic feature, stenosis diameter, histologic features, metastasis, tracheal involvement, symptoms, and type of prothesis). Two factors had a P value approaching significance: there were slightly longer survival rates in patients with a stenosis diameter less than 7 mm (P < 0.07), and with stenosis located in the lower third and cardia (P < 0.07). By multivariate analysis (Cox model), prognostic significance was found in only one factor: the location in the lower third and cardia (P = 0.002, relative risk = 3). The quality of life after EP placement was briefly improved: 80% of 73 evaluable patients had improvement in dysphagia for a mean duration of 3.7 months ± 2 (2 SD), especially patients with a good general status (0 and 1; P < 0.01); and 45% of patients had improvement of their general status for a mean duration of 4.1 months ± 2 (2 SD). Minor complications related to EP placement were observed in 40% of patients (pain, obstruction, and mobilization), and severe complications were observed in 20% (perforation, 11 cases; fistulae, 5 cases, with death in 3 cases; hemorrhages, 4 cases). In conclusion, EP is a good palliative treatment, although complications are frequent, and evaluation of patient comfort is required to compare this procedure with other available techniques.
AB - Esophageal prothesis (EP) is a palliative treatment for inoperable neoplastic stenosis. Ninety‐one patients were candidates for EP placement between 1978 and 1983. EP placement was successful in 77 patients. Of these: 85% had primary esophageal cancer; 15% had bronchial or mediastinal carcinoma; 83% had stenosis in the middle third. Dysphagia was the main symptom in 84%, and tracheoesophageal fistulae in 16%. The observed median survival was 3.2 months ± 1.9 (2 standard deviations [SD]), and the survival rate at 1 year was 7%. With the single‐factor analysis method, not one of 12 factors presented any significance (age, sex, general status, anterior treatment, lesion site, endoscopic feature, stenosis diameter, histologic features, metastasis, tracheal involvement, symptoms, and type of prothesis). Two factors had a P value approaching significance: there were slightly longer survival rates in patients with a stenosis diameter less than 7 mm (P < 0.07), and with stenosis located in the lower third and cardia (P < 0.07). By multivariate analysis (Cox model), prognostic significance was found in only one factor: the location in the lower third and cardia (P = 0.002, relative risk = 3). The quality of life after EP placement was briefly improved: 80% of 73 evaluable patients had improvement in dysphagia for a mean duration of 3.7 months ± 2 (2 SD), especially patients with a good general status (0 and 1; P < 0.01); and 45% of patients had improvement of their general status for a mean duration of 4.1 months ± 2 (2 SD). Minor complications related to EP placement were observed in 40% of patients (pain, obstruction, and mobilization), and severe complications were observed in 20% (perforation, 11 cases; fistulae, 5 cases, with death in 3 cases; hemorrhages, 4 cases). In conclusion, EP is a good palliative treatment, although complications are frequent, and evaluation of patient comfort is required to compare this procedure with other available techniques.
UR - http://www.scopus.com/inward/record.url?scp=0022620767&partnerID=8YFLogxK
U2 - 10.1002/1097-0142(19860401)57:7<1426::AID-CNCR2820570731>3.0.CO;2-2
DO - 10.1002/1097-0142(19860401)57:7<1426::AID-CNCR2820570731>3.0.CO;2-2
M3 - Article
C2 - 2418940
AN - SCOPUS:0022620767
SN - 0008-543X
VL - 57
SP - 1426
EP - 1431
JO - Cancer
JF - Cancer
IS - 7
ER -