Safety and Efficacy of Self-Expandable Metallic Stent Placement Using Low Radial Force Stent for Malignant Dysphagia after Radiotherapy

Ishioka M.a· Yoshio T.a· Sasaki T.a· Tamashiro A.a,b· Yoshizawa N.a,c· Suzuki K.a· Tokura J.a· Namikawa K.a· Tokai Y.a· Yoshimizu S.a· Horiuchi Y.a· Ishiyama A.a· Hirasawa T.a· Chin K.d· Ogura M.d· Sasahira N.a· Fujisaki J.a

Author affiliations

aDepartment of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
bDepartment of Gastroenterology, Matsumoto Kyoritsu Hospital, Nagano, Japan
cDepartment of Gastroenterology, Sagamihara Kyodo Hospital, Sagamihara, Japan
dDepartment of Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

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Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: September 25, 2021
Accepted: January 16, 2022
Published online: February 18, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Introduction: We aimed to investigate the safety and efficacy of self-expandable metallic stent (SEMS) placement in patients with prior radiotherapy (RT) using the Niti-S stent, which is characterized by low radial force, in comparison to patients without prior RT. Methods: A consecutive series of 83 patients who were treated by SEMS placement using Niti-S stent for severe malignant esophageal obstruction or fistula were enrolled. The adverse event rates and efficacy were retrospectively compared between patients with/without prior RT before SEMS placement (RT group [n = 32] versus non-RT group [n = 51]). Results: The incidence rate of major adverse events in the RT group was 6.3% and was not significantly different from that in the non-RT group (5.9%, p = 0.95). Among the RT group, 84.4% were able to resume oral intake within a median of 2 days. Among the patients with fistula, 78.6% could resume oral intake and survive for 73 days after SEMS placement. Cox proportional hazard regression analysis identified significant factors affecting overall survival to be prior RT (hazard ratio [HR]: 1.96), low performance status (HR: 3.87), and subsequent anticancer treatment after SEMS placement (HR: 0.41). However, compared to the non-RT group, the RT group had received longer duration of anticancer treatment before SEMS placement and a lower rate of subsequent anticancer treatment after SEMS placement. Conclusions: With the Niti-S stent, the incidence of major adverse events was sufficiently low even for patients after RT. SEMS with low radial force would be an effective palliative treatment option for patients, regardless of prior RT.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Research Article

Received: September 25, 2021
Accepted: January 16, 2022
Published online: February 18, 2022

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

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