Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula.

Abstract

INTRODUCTION Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer. METHODS In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study. RESULTS From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95% confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95% CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95% CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95% CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95% CI, 0.03-0.59) remained as significant factors that impacted survival. CONCLUSIONS Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.

DOI: 10.1097/MAJ.0b013e3182367b6a

Cite this paper

@article{Chung2012AirwayUS, title={Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula.}, author={F K Chung and Horng-Chyuan Lin and Chun-Liang Chou and Hao-Cheng Chen and Chih-Hsi Scott Kuo and Chih-Teng Yu and Shu-Min Lin and H P Kuo}, journal={The American journal of the medical sciences}, year={2012}, volume={344 2}, pages={105-9} }