The results of stenting patients with upper-third and middle-third esophageal cancer
Киркилевский С.И., Крахмалев П.С., Фридель Р.И.
Summary. Relevance. At the time of diagnosis patients with esophageal cancer (EC) are often inoperable due to locally advanced process. Life expectancy in case of incurable patient with severe dysphagia comprises 90 days in average. Radical treatment can be performed only in 20–30% of patients with a 5-year survival rate from 10.3 to 35%. Objective. Assessing short-term and long-term outcomes of stenting patients with EC depending on the localization of the primary tumor. Materials and methods. We analyzed our experience of using intraesophageal self-expanding stents in ЕС patients. 49 of them had tumor in upper-third of esophagus and 73 patients had middle-third tumors location as compared with those with stoma implantation (53 cases) in EC patients. Results. All patients who were stented had significantly lower grade of dysphagia and could eat in the usual way. It also improved quality of life, and many of such patients had an opportunity to continue treatment. It has been revealed that stenting of inoperable cancer patients of the upper and middle-third EC gives benefit to patients as it allows patients to continue to eat naturally and thereby significantly improves the quality of life in contrast to stoma placement. Patients of the upper esophagus who were not stented because of fistula formation had significantly better long-term survival than EC patients with stoma and similar cancer patients of the middle esophagus, and the survival rate of patients with cancer of the upper esophagus after stenting is not for fistula was significantly better than with their availability. Patients with cancer of the middle esophagus, who experienced stent placement because of fistulae, had the same long-term survival results as cancer patients of the middle part of the esophagus who were not stented because of the fistula. It indicates high efficacy of stenting in cancer of the middle-third esophagus with presence of fistula. Conclusion. Stenting of inoperable cancer patients with upper and middle-third of esophagus shows significant benefit. It allows patients to eat naturally, and thereby significantly improves the quality of life in comparison with stoma placement.
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