Abstract
BackgroundSelf-expandable metal stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them.MethodsWe retrospectively analyzed 308 patients with esophageal cancer who underwent fully covered SEMS insertion (stent group) or PG (gastrostomy group) for dysphagia due to tumor. Patients with other causes of dysphagia, such as radiation-induced or postoperative stricture, were excluded from the study. Clinical outcomes were compared between the two groups, including overall survival and need for additional intervention and postprocedural nutritional status.ResultsAt baseline, the stent group (n = 169) had more stage IV patients, less cervical cancers, and received radiotherapy and esophagectomy less often than the gastrostomy group (n = 64). The Kaplan-Meier curves showed higher overall survival in the gastrostomy group than in the stent group. Multivariate analysis revealed that PG was associated with better survival compared with SEMS insertion (hazard ratio 0.541, 95% confidence interval 0.346–0.848, p = 0.007). In addition, the gastrostomy group needed additional intervention less often (3.1% vs. 21.9%, p < 0.001) and experienced less decrease in serum albumin levels (-0.15 ± 0.56 g/dL vs. -0.39 ± 0.58 g/dL, p = 0.011) than the stent group after procedure.ConclusionsOur data suggested that, compared with SEMS insertion, PG is associated with better overall survival in patients with esophageal cancer and dysphagia. Stabilized nutritional status by PG may play a role in improving patient survival.
Highlights
The incidence of esophageal cancer is increasing, and esophageal cancer ranked ninth for cancer incidence and sixth for cancer death in 2013 [1]
Multivariate analysis revealed that Percutaneous gastrostomy (PG) was associated with better survival compared with self-expandable metal stent (SEMS) insertion
Many patients with esophageal cancer are diagnosed at an advanced stage, and dysphagia is their predominant symptom Fully or partially covered self-expandable metal stent (SEMS) placement for palliation of dysphagia caused by esophageal cancer has become the standard of care because of its better efficacy compared to other treatment modalities [2,3]
Summary
The incidence of esophageal cancer is increasing, and esophageal cancer ranked ninth for cancer incidence and sixth for cancer death in 2013 [1]. Many patients with esophageal cancer are diagnosed at an advanced stage, and dysphagia is their predominant symptom Fully or partially covered self-expandable metal stent (SEMS) placement for palliation of dysphagia caused by esophageal cancer has become the standard of care because of its better efficacy compared to other treatment modalities [2,3]. As weight loss and malnutrition are determinants of tolerance to treatment and survival [9], restoring swallowing and maintaining nutritional status should be pursued in patients with esophageal cancer and dysphagia. The present study aimed to compare the efficacy of fully covered SEMS (FCSEMS) insertion and PG feeding in terms of clinical outcomes, including overall survival and nutritional status, in patients with esophageal cancer and dysphagia. Self-expandable metal stent (SEMS) insertion and percutaneous gastrostomy (PG) feeding are commonly used for patients with esophageal cancer and dysphagia. This study aimed to compare outcomes between SEMS insertion and PG feeding for them
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
