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Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status

European Journal of Clinical Nutrition volume 70, pages 409–410 (2016)Cite this article

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Abstract

Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered.

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References

  1. Lecleire S, Di Fiore F, Antonietti M, Ben Soussan, Hellot F, Grigioni S et al. Undernutrition is predictive of early mortality after palliative self-expanding metal stent insertion in patients with inoperable or recurrent esophageal cancer. Gastrointest Endosc 2006; 64: 479–484.

    Article  Google Scholar 

  2. Yakami M, Mitsumori M, Sai H, Nagata Y, Hiraoka M, Nishimura Y . Development of severe complications caused by stent placement followed by definitive radiation therapy for T4 esophageal cancer. Int J Clin Oncol 2003; 8: 395–398.

    Article  Google Scholar 

  3. Adler G, Fang J, Wong R, Wills J, Wills J, Hilden K . Placement of Poliflex stents in patients with locally advanced esophageal cancer is safe and improves dysphagia during neoadjuvant therapy. Gastrointest Endosc 2009; 70: 614–619.

    Article  Google Scholar 

  4. Martin RC 2nd, Cannon RM, Brown RE, Ellis S, Williams S, Scoggins C et al. Evaluation of quality of life following placement of self-expanding plastic stents as a bridge to surgery in patients receiving neoadjuvant therapy for esophageal cancer. Oncologist 2014; 19: 259–265.

    Article  CAS  Google Scholar 

  5. Bower M, Jones W, Vessels B, Scoggins C, Martin R . Nutritional support with endoluminal stenting during neoadjuvant therapy for esophageal malignancy. Ann Surg Oncol 2009; 16: 3161–3168.

    Article  Google Scholar 

  6. Pellen M, Sabri S, Gilani S, Jain P . Safety and efficacy of self- expanding removable metal stents during neoadjuvant chemotherapy for ressectable esophageal cancer. Dis Esophagus 2012; 25: 48–53.

    Article  CAS  Google Scholar 

  7. Lopes TL, Eloubeidi MA . A pilot study of fully covered self-expandable metal stents prior to neoadjuvant therapy for locally advanced esophageal cancer. Dis Esophagus 2010; 23: 309–315.

    Article  CAS  Google Scholar 

  8. Siddiqui AA, Sarkar A, Beltz S, Lewis J, Loren D, Kowalski T et al. Placement of fully covered self-expandable metal stents in patients with locally advanced esophageal cancer before neoadjuvant therapy. Gastrointest Endosc 2012; 76: 44–51.

    Article  Google Scholar 

  9. Bauer J, Capra S, Ferguson M . Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 2002; 56: 779–785.

    Article  CAS  Google Scholar 

  10. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M . ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003; 22: 415–421.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal

    S Mão-de-Ferro, M Serrano, S Ferreira, I Rosa, P Lage & A D Pereira

  2. Department of Nutrition, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal

    D P Alexandre

  3. Department of Oncology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal

    J Freire

  4. Department of Radiation Oncology, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal

    L Mirones

  5. Department of Surgery, Instituto Português de Oncologia de Lisboa Dr. Francisco Gentil, EPE, Lisbon, Portugal

    R Casaca & A Bettencourt

Authors
  1. S Mão-de-Ferro
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  2. M Serrano
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  3. S Ferreira
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  4. I Rosa
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  5. P Lage
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  6. D P Alexandre
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  7. J Freire
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  8. L Mirones
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  9. R Casaca
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  10. A Bettencourt
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  11. A D Pereira
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Correspondence to S Mão-de-Ferro.

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Mão-de-Ferro, S., Serrano, M., Ferreira, S. et al. Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status. Eur J Clin Nutr 70, 409–410 (2016). https://doi.org/10.1038/ejcn.2015.206

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  • DOI: https://doi.org/10.1038/ejcn.2015.206

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