LONG-TERM ADVERSE EVENTS DUE TO SELF-EXPANDABLE METALLIC STENTS IN PATIENTS WITH ADVANCED ESOPHAGEAL CANCER

Aims:

Self-expandable metallic stents (SEMS) are accepted as best palliative treatment option for patients with advanced esophageal cancer who has already dysphagia. Adverse events (AE), especially in patients who has longer survival expentancy are a major concern. We aimed that to assess the AE of patients with esophageal SEMS who survived longer than 6 months.

Methods:

The data of patients with SEMS placed at Kocaeli University Gastroenterology Department, between 2007 and 2015 who have survived for longer than 6 months were retrospectively evaluated. Placement of the stent in the desired region, and reaching expected clinical well-being (and dysphagia correction) defined as technical success and clinical success, respectively.

Results:

Seventy two patients (M/F: 52/20) whom median age 56 (44 – 88) were included. While technical success was achieved in all patients, clinical success obtained in sixty nine (95.8%) patients. Median stent patency was 8.8 months. AE happened in 32 patients (44.4%), 53 AE in totally (mean, 1.65 AE per patient). Endoscopic management of AE was successful in 79.2%. The univariate analysis revealed that multi morbidity, use of dual anticoagulant therapy, age and post stent replacement radiotherapy associated with higher risk of AE. The multivariate analysis revealed that again multi morbidity (p = 0.02) and radiotherapy requirement (p = 0.036) (especially in cases performed due to bleeding) were associated with AE.

Conclusions:

AE are not rare in patients with esophageal cancer who has been placed long-term SEMS. Fortunately, AE were not related to higher mortality rate and many of AE could be managed successfully in endoscopic manner. SEMS stands as a suitable option for malignant esophageal diseases in patients whose life expectancy is longer than 6 months.