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Prior chemoradiotherapy is associated with a higher life‐threatening complication rate after palliative insertion of metal stents in patients with oesophageal cancer
Author(s) -
LECLEIRE S.,
DI FIORE F.,
BENSOUSSAN E.,
ANTONIETTI M.,
HELLOT M.F.,
PAILLOT B.,
LEREBOURS E.,
DUCROTTÉ P.,
MICHEL P.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.02946.x
Subject(s) - medicine , dysphagia , chemoradiotherapy , stent , self expandable metallic stent , odds ratio , complication , surgery , cancer , radiation therapy
Summary Background Self‐expanding metal stents are used routinely to palliate dysphagia due to oesophageal cancer. Study aim To compare the frequency of life‐threatening complications after self‐expanding metal stent insertion, depending on whether patients received prior chemoradiotherapy or no treatment. Patients and methods During 7 years, 116 consecutive patients were treated at a single centre in a palliative intent by insertion of self‐expanding metal stent for dysphagia due to an oesophageal cancer. Patients were retrospectively separated into two groups: patients with chemoradiotherapy before self‐expanding metal stent insertion (group 1, n = 56) and patients with no treatment before or after self‐expanding metal stent insertion (group 2, n = 60). Life‐threatening complications were compared and predictive risk factors of postprocedure complications were identified. Results Median dysphagia was significantly improved during the first month (grade 3 to grade 1 in the two groups). Early and late major complications occurred more frequently in group 1 (23.2% vs. 3.3%; P < 0.002 and 21.6% vs. 5.1%; P < 0.02 respectively). Prior chemoradiotherapy was the only independent predictive factor of postprocedure major complications, with an odds ratio of 5.59 (CI 95% 1.7–18.1). Conclusions Life‐threatening complications after palliative self‐expanding metal stent placement seem to occur more frequently in patients with prior chemoradiotherapy. Prevention of these severe complications should be considered before stenting.