Division of Chest Surgery, Department of Surgery, School of Medicine, Toho University, 6-11-1, Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
Division of Respiratory Medicine, Toho University School of Medicine, Tokyo, Japan.
Gen Thorac Cardiovasc Surg. 2021 Sep;69(9):1303-1307. doi: 10.1007/s11748-021-01634-0. Epub 2021 Apr 12.
Silicone airway stents are used to manage central airway stenosis or obstruction, although their impact on long-term survival remains unknown in patients with central airway stenosis or obstruction due to thoracic malignancy. In this study, we retrospectively analyzed the impact of silicone stents on survival.
We retrospectively analyzed clinical data of 106 patients with central airway stenosis or obstruction due to thoracic malignancy treated by stenting at Toho University Omori Medical Center between 1998 and 2018.
Patients treated with silicone stents had significantly higher survival rates than patients treated with metallic stents (p = 0.0173). Silicone stents patients also had significantly more additional treatments for thoracic malignancy after stenting than metallic stents patients (p = 0.0007). Notably, significantly more silicone stents patients underwent chemoradiotherapy or radiotherapy (p = 0.0268, p = 0.0300). During multivariate analyses, the additional treatment, including chemoradiotherapy or radiotherapy, was an independent optimal prognostic factor.
Silicone stents patients had significantly higher survival rates than metallic stents patients. Although stenting for airway stenosis or obstruction due to thoracic malignancy may be mainly palliative, additional treatments after stenting should be considered to improve the prognoses of patients with airway stenosis or obstruction due to thoracic malignancy.
硅酮气道支架用于治疗中央气道狭窄或阻塞，但由于胸恶性肿瘤导致的中央气道狭窄或阻塞患者的长期生存率尚不清楚。本研究回顾性分析了硅酮支架对生存率的影响。
我们回顾性分析了 1998 年至 2018 年在东京都立大学大森医疗中心接受支架置入治疗的 106 例因胸恶性肿瘤导致中央气道狭窄或阻塞患者的临床资料。
与金属支架治疗的患者相比，接受硅酮支架治疗的患者生存率显著更高（p=0.0173）。与金属支架治疗的患者相比，硅酮支架治疗的患者在支架置入后接受更多的针对胸恶性肿瘤的附加治疗（p=0.0007）。值得注意的是，接受更多的硅酮支架治疗的患者接受了放化疗或放疗（p=0.0268，p=0.0300）。多因素分析中，附加治疗（包括放化疗或放疗）是独立的最佳预后因素。
与金属支架治疗的患者相比，硅酮支架治疗的患者生存率显著更高。虽然胸恶性肿瘤所致气道狭窄或阻塞的支架置入主要是姑息性的，但支架置入后应考虑进行附加治疗，以改善胸恶性肿瘤所致气道狭窄或阻塞患者的预后。
