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• W2000067099 abstract "Background Self-expandable metal stents (SEMSs) are an established palliative therapy for esophageal cancer. SEMS placement for cancers near the upper esophageal sphincter (UES) is controversial because of a perceived increased risk of complications. Objective To compare outcomes after patients stented for proximal esophageal cancer (PC) and distal esophageal cancer (DC). Design Matched case-control study from a prospective database. Setting Tertiary referral center, Tenwek Hospital, Bomet, Kenya. Patients All patients with PC located within 6 cm of the UES were matched with randomly selected controls with DC. Interventions Outcomes of PC cases were compared with those of DC controls. Main Outcome Measurements Dysphagia score, complications, median survival. Results A total of 151 patients with PC were identified and were randomly matched with DC controls. Ninety-three case-control pairs had adequate follow-up information available. Mean dysphagia scores (scale 0-4) improved from 3.4 and 3.3 before stenting for PC and DC, respectively, to 1.5 after stenting for both groups (P = .93). Early complications occurred in 6.5% of PC cases and 9.7% of DC controls (P = .44). Late complications occurred in 20.4% of PC cases and 15.1% of DC controls (P = .25). Median survival was 210 days for PC cases and 272 days for DC controls (P = .25). Outcomes were similar for the subgroup of PC cases whose cancer extended to within 2 cm of the UES. Limitation An important limitation is the absence of adequate follow-up data for 58 of the 151 case-control pairs. Conclusions SEMSs effectively palliate dysphagia in PC cases, whereas complication and survival rates are not statistically different from those of DC controls. Self-expandable metal stents (SEMSs) are an established palliative therapy for esophageal cancer. SEMS placement for cancers near the upper esophageal sphincter (UES) is controversial because of a perceived increased risk of complications. To compare outcomes after patients stented for proximal esophageal cancer (PC) and distal esophageal cancer (DC). Matched case-control study from a prospective database. Tertiary referral center, Tenwek Hospital, Bomet, Kenya. All patients with PC located within 6 cm of the UES were matched with randomly selected controls with DC. Outcomes of PC cases were compared with those of DC controls. Dysphagia score, complications, median survival. A total of 151 patients with PC were identified and were randomly matched with DC controls. Ninety-three case-control pairs had adequate follow-up information available. Mean dysphagia scores (scale 0-4) improved from 3.4 and 3.3 before stenting for PC and DC, respectively, to 1.5 after stenting for both groups (P = .93). Early complications occurred in 6.5% of PC cases and 9.7% of DC controls (P = .44). Late complications occurred in 20.4% of PC cases and 15.1% of DC controls (P = .25). Median survival was 210 days for PC cases and 272 days for DC controls (P = .25). Outcomes were similar for the subgroup of PC cases whose cancer extended to within 2 cm of the UES. An important limitation is the absence of adequate follow-up data for 58 of the 151 case-control pairs. SEMSs effectively palliate dysphagia in PC cases, whereas complication and survival rates are not statistically different from those of DC controls." @default.
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• W2000067099 date "2011-06-01" @default.
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• W2000067099 title "Stents for proximal esophageal cancer: a case-control study" @default.
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• W2000067099 doi "https://doi.org/10.1016/j.gie.2010.11.036" @default.
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