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Long-term clinical outcomes of self-expanding metal stents for treatment of malignant gastroesophageal junction obstructions and prognostic factors for stent patency: effects of anticancer treatments

Authors
 Jae Jun Park  ;  Yong Chan Lee  ;  Beom Kyung Kim  ;  Jie-Hyun Kim  ;  Jun Chul Park  ;  Yu Jin Kim  ;  Sang Kil Lee  ;  Si Young Song  ;  Jae Bock Chung 
Citation
 DIGESTIVE AND LIVER DISEASE, Vol.42(6) : 436-440, 2010 
Journal Title
 DIGESTIVE AND LIVER DISEASE 
ISSN
 1590-8658 
Issue Date
2010
MeSH
Adenocarcinoma/complications ; Adenocarcinoma/diagnosis ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/complications ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/surgery ; Endoscopy, Gastrointestinal ; Esophageal Neoplasms/complications* ; Esophageal Neoplasms/diagnosis ; Esophageal Neoplasms/surgery ; Esophagectomy/methods* ; Esophagogastric Junction/surgery* ; Female ; Follow-Up Studies ; Gastric Outlet Obstruction/diagnosis ; Gastric Outlet Obstruction/etiology ; Gastric Outlet Obstruction/surgery* ; Humans ; Male ; Middle Aged ; Prognosis ; Prosthesis Design ; Prosthesis Implantation/methods* ; Retrospective Studies ; Stents* ; Time Factors
Keywords
Complication ; Gastroesophageal junction ; Malignant obstruction ; SEMS ; Stent patency
Abstract
BACKGROUND: Self-expanding metal stent has emerged as an effective treatment option for malignant gastroesophageal junction obstruction. However, data on the clinicopathologic factors associated with stent patency are still lacking. AIM: To investigate the long-term clinical outcomes and prognostic factors, including treatment modalities, affecting stent patency in patients with malignant gastroesophageal junction obstruction given self-expanding metal stent insertions. METHODS: A total 89 patients who underwent self-expanding metal stent insertion for malignant gastroesophageal junction obstruction were enrolled. We analysed technical and clinical success rates, complications, and prognostic factors affecting stent patency. RESULTS: Self-expanding metal stent insertion was successful in all patients and clinical improvement was achieved in 93.3%. Stent malfunction occurred in 32.9% of patients. The median overall survival time and stent patency time were 143 (95% CI: 99-187) and 190 days (95% CI: 108-272), respectively. In multivariate analysis, radiation therapy after stent placement significantly prolonged stent patency (OR: 0.221; 95% CI: 0.055-0.884; p=0.033). A higher migration rate was observed in those patients given chemotherapy after covered self-expanding metal stent placement (no anticancer treatment: 10.0%, chemotherapy: 42.9%, chemoradiation therapy: 9.1%, p=0.042). CONCLUSIONS: Self-expanding metal stent is a feasible and effective treatment for malignant gastroesophageal junction obstruction. Radiation therapy after stent placement significantly prolongs overall stent patency and chemotherapy increases the migration rate of covered stents
Full Text
http://www.sciencedirect.com/science/article/pii/S1590865809003326
DOI
10.1016/j.dld.2009.07.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Yoo Jin(김유진)
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Jae Jun(박재준)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Chung, Jae Bock(정재복)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101685
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