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Jari Räsänen



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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-02 - Predicting Stent Failure in Malignant Esophageal Obstruction (ID 14438)

      16:45 - 18:00  |  Author(s): Jari Räsänen

      • Abstract
      • Slides

      Background

      Esophageal malignant obstruction is commonly caused by esophageal cancer and seldom caused by malignant disease not originating from the esophagus. Malnutrition and feedin intolerance are commonly present. Palliation is commonly achieved with insertion of an esophageal stent, which has been deemed safe and effective in previous trials. Our objective was to assess the factors predicting the failure of stent treatment in malignant obstruction of the esophagus.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      This was a retrospective cohort study with primary end point of stent failure. Stent failure is defined here as any major complication caused by the stent (perforation, fistula, etc.), migration of the stent the stomach or any need for non-planned urgent removal of the stent. Patient demographic details, stent insertion details (indication, date, location, size, type of stent), complications related to stent-insertion, operations associated with stent insertion, and possible time of death were collected.

      4c3880bb027f159e801041b1021e88e8 Result

      Between March 2005 and December 2013 there were 410 esophageal stents placed for treatment of malignant obstruction. The most common pathology was esophageal cancer (N = 333, 81.2%), lung cancer was the cause in 44 (10.7%) and mesothelioma and breast cancer were found were both found in 5 patients (1.2%), the remaining 23 patients had cancers of various histologies. Median OS was 149 days from stent insertion (IQR: 63-297 days). Stent failure rate in the first 6 months was 27.3% (N = 112) with median time to failure being 46 days (IQR: 9-105). Cox multivariate regression analysis was done by backwards elimination method with a p-value limit of 0.2, the results are shown in Table 1.

      Table 1 Multivariate Cox regression analysis of factors affecting stent failure
      HR 95% CI p
      Age 0.96 0.97-1.00 0.112
      Proximal stent location* 1.68 1.15-2.44 0.00714
      *Top edge under 25 cm from incisors

      8eea62084ca7e541d918e823422bd82e Conclusion

      In the setting of malignant obstruction of the esophagus, stent failure rate is related to the location of the inserted stent. More proximal stents have a higher rate of failure in multivariate analysis (HR =1.68, p = 0.00714).

      6f8b794f3246b0c1e1780bb4d4d5dc53

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