Bøgh Mads, Heinonen Sebastian, Larsen Dalia Gustaityté, Gade Søren, Schytte Sten, Pedersen Ulrik, Kjaergaard Thomas
Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Otorhinolaryngology, Head and Neck Surgery, Aalborg University Hospital, Aalborg, Denmark.
BMC Pulm Med. 2024 Dec 29;24(1):635. doi: 10.1186/s12890-024-03432-9.
To examine the outcome of palliative endoscopic treatment of malignant central airway obstruction (CAO) and identify predictors for Days Alive and Out of Hospital (DAOH), overall survival and treatment related complications.
Consecutive adult patients treated endoscopically for malignant CAO at Aarhus University Hospital from 2012 to 2022 were included in the study. Statistical analyses were carried out to identify predictors for DAOH, survival and complications.
127 consecutive patients met the inclusion criteria. The majority of patients were categorised with stage IV lung cancer, the majority being males, with a median age of 67 years. The endoscopic interventions were mainly tumour debulking combined with airway stent insertion or tumour debulking alone. The complication rate was 21.0% and the mortality rate was 3.9%. In total, 89.8% of the patients experienced symptom relief following surgery, and the majority (92.1%) were discharged from hospital within two days after intervention. Mean survival time following intervention was 144 days, mean DAOH was 20.8 and mean DAOH was 157. Survival was associated with comorbidity, type of intervention, preoperative respiratory support and postoperative oncologic treatment. A high preoperative ASA-score, preoperative respiratory support, urgency of intervention, female gender and insertion of airway stent were predictors for a poorer DAOH-outcome.
Endoscopic palliative treatment of malignant CAO is generally feasible and safe, offering symptom relief in most cases. The method is considered an effective measure for short to median term palliation of respiratory distress.
探讨恶性中央气道梗阻（CAO）姑息性内镜治疗的结果，并确定存活出院天数（DAOH）、总生存期及治疗相关并发症的预测因素。
纳入2012年至2022年在奥胡斯大学医院接受内镜治疗恶性CAO的成年连续患者。进行统计分析以确定DAOH、生存期和并发症的预测因素。
127例连续患者符合纳入标准。大多数患者被归类为IV期肺癌，大多数为男性，中位年龄67岁。内镜干预主要是肿瘤减容联合气道支架置入或单纯肿瘤减容。并发症发生率为21.0%，死亡率为3.9%。总共89.8%的患者术后症状缓解，大多数（92.1%）在干预后两天内出院。干预后的平均生存时间为144天，平均DAOH为20.8天，平均DAOH为157天。生存期与合并症、干预类型、术前呼吸支持和术后肿瘤治疗有关。术前ASA评分高、术前呼吸支持、干预紧迫性、女性性别和气道支架置入是DAOH结局较差的预测因素。
恶性CAO的内镜姑息治疗总体上可行且安全，大多数情况下可缓解症状。该方法被认为是短期至中期缓解呼吸窘迫的有效措施。
