Martins Bruno Costa, Gregorio Julia Mayumi, Sueta Rafael Utimura, Centeno Déborah Marques, Mendieta Pastor Joaquín Ortiz, de Lima Marcelo Simas, Moura Renata Nobre, Lenz Luciano, Pennacchi Caterina Maria Pia Simioni, Machado Andressa Abnader, Sallum Rubens Antonio Aissar, Maluf-Filho Fauze
Department of Endoscopy, Instituto do Cancer do Estado de São Paulo, Sao Paulo, Brazil.
Dis Esophagus. 2025 May 3;38(3). doi: 10.1093/dote/doaf039.
Esophageal cancer is often diagnosed in advanced stages, leading to significant dysphagia and affecting patients' quality of life. This study aims to evaluate the efficacy and safety of self-expanding metallic stents (SEMS) for the palliative treatment of advanced esophageal cancer. This observational study was conducted in a tertiary cancer center, analyzing a prospectively maintained database where those undergoing SEMS placement between January 2009 and January 2021 were analyzed. Technical and clinical success rates, improvement in dysphagia and adverse events were analyzed. A total of 364 patients were included (291 men, mean age 60.8 years). The technical success was 100%, with 88% of patients showing improvement in dysphagia after stent placement. Adverse events occurred in 58% of cases, with stent-induced fistula (14%) and stent migration (9%) being the most common. There was no relationship between stent covering (partially versus fully covered) and adverse events (fistula P = 0.056; migration P = 0.264; in/overgrowth P = 0.825). Median overall survival was 207.2 days, with 1-month and 3-month survival rates of 82% and 66%, respectively. Placement of esophageal SEMS in patients with advanced esophageal tumors has high technical and clinical success rates. It immediately improves dysphagia in most patients. Stent-induced fistula and stent migration are the most common adverse events. Their occurrence is not influenced by previous chemo radiation or the type of stent covering. In most cases, they can be endoscopically managed.
食管癌常于晚期被诊断出来，导致严重吞咽困难，影响患者生活质量。本研究旨在评估自膨式金属支架（SEMS）用于晚期食管癌姑息治疗的疗效和安全性。这项观察性研究在一家三级癌症中心进行，分析了一个前瞻性维护的数据库，其中纳入了2009年1月至2021年1月期间接受SEMS置入的患者。分析了技术成功率、临床成功率、吞咽困难改善情况及不良事件。共纳入364例患者（291例男性，平均年龄60.8岁）。技术成功率为100%，88%的患者在支架置入后吞咽困难有所改善。58%的病例发生了不良事件，其中支架引起的瘘管（14%）和支架移位（9%）最为常见。支架覆盖情况（部分覆盖与完全覆盖）与不良事件（瘘管P = 0.056；移位P = 0.264；内生/过度生长P = 0.825）之间无相关性。中位总生存期为207.2天，1个月和3个月生存率分别为82%和66%。对晚期食管肿瘤患者置入食管SEMS具有较高的技术和临床成功率。它能立即改善大多数患者的吞咽困难。支架引起的瘘管和支架移位是最常见的不良事件。它们的发生不受既往放化疗或支架覆盖类型的影响。在大多数情况下，它们可以通过内镜处理。
