Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer
Background Self-expanding metallic stents (SEMSs) have been used as a bridge to surgery, relieving dysphagia and maintaining nutrition, in patients with operable but obstructive esophageal cancer (EC). However, the impact of SEMSs on oncologic outcomes is unknown. The aim of this study was to evalua...
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2015
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| Online Access: | http://hdl.handle.net/10725/14216 https://doi.org/10.1016/j.jamcollsurg.2014.11.028 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://www.sciencedirect.com/science/article/abs/pii/S1072751514018596 |
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| _version_ | 1864513469207805952 |
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| author | Mariette, Christophe |
| author2 | Gronnier, Caroline Duhamel, Alain Mabrut, Jean-Yves Bail, Jean-Pierre Carrere, Nicolas Lefevre, Jérémie H. Meunier, Bernard Collet, Denis Piessen, Guillaume |
| author2_role | author author author author author author author author author |
| author_facet | Mariette, Christophe Gronnier, Caroline Duhamel, Alain Mabrut, Jean-Yves Bail, Jean-Pierre Carrere, Nicolas Lefevre, Jérémie H. Meunier, Bernard Collet, Denis Piessen, Guillaume |
| author_role | author |
| dc.contributor.none.fl_str_mv | Chemaly, Rodrigue |
| dc.creator.none.fl_str_mv | Mariette, Christophe Gronnier, Caroline Duhamel, Alain Mabrut, Jean-Yves Bail, Jean-Pierre Carrere, Nicolas Lefevre, Jérémie H. Meunier, Bernard Collet, Denis Piessen, Guillaume |
| dc.date.none.fl_str_mv | 2015 2022-11-04T14:27:41Z 2022-11-04T14:27:41Z 2022-11-04 |
| dc.identifier.none.fl_str_mv | 1072-7515 http://hdl.handle.net/10725/14216 https://doi.org/10.1016/j.jamcollsurg.2014.11.028 Mariette, C., Gronnier, C., Duhamel, A., Mabrut, J. Y., Bail, J. P., Carrere, N., ... & Bertrand, C. (2015). Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes. Journal of the American College of Surgeons, 220(3), 287-296. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://www.sciencedirect.com/science/article/abs/pii/S1072751514018596 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Journal of the American College of Surgeons |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer Impact on Oncologic Outcomes |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background Self-expanding metallic stents (SEMSs) have been used as a bridge to surgery, relieving dysphagia and maintaining nutrition, in patients with operable but obstructive esophageal cancer (EC). However, the impact of SEMSs on oncologic outcomes is unknown. The aim of this study was to evaluate the impact of SEMS insertion before EC surgery on oncologic outcomes. Study Design From 2000 to 2010, two thousand nine hundred and forty-four patients who underwent an operation for EC with a curative intent were included in a multicenter European cohort. Through propensity score analysis, patients who underwent SEMS insertion (SEMS group, n = 38) were matched 1:4 to control patients who did not undergo SEMS insertion (control group, n = 152). Results The SEMS and control groups were comparable according to age, sex, tumor location, clinical stage, American Society of Anesthesiologists score, dysphagia, malnutrition, neoadjuvant treatment administration, histology, and surgical procedure. Self-expanding metallic stent insertion was complicated by tumoral perforation in 2 patients. The in-hospital postoperative mortality and morbidity rates for the SEMS vs control groups were 13.2% vs 8.6% (p = 0.370) and 63.2% vs 59.2% (p = 0.658), respectively. The R0 resection rate (71.0% vs 85.5%; p = 0.041), median time to recurrence (6.5 vs 9.0 months; p = 0.040), and 3-year overall survival (25% vs 44%; p = 0.023) were significantly reduced in the SEMS group, and the 3-year locoregional recurrence rate was increased (62% vs 34%; p = 0.049). The results remained significant after excluding SEMS-related esophageal perforations. After adjusting for confounding factors, SEMS insertion was a predictor of poor prognosis (hazard ratio = 1.6; p = 0.038). Conclusions Self-expanding metallic stent insertion, as a bridge to surgery, has a negative impact on oncologic outcomes in EC. Clinicaltrials.gov ID: NCT 01927016. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_5ea80b4f058769516fa6d5a2d9a9153b |
| identifier_str_mv | 1072-7515 Mariette, C., Gronnier, C., Duhamel, A., Mabrut, J. Y., Bail, J. P., Carrere, N., ... & Bertrand, C. (2015). Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes. Journal of the American College of Surgeons, 220(3), 287-296. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/14216 |
| publishDate | 2015 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal CancerImpact on Oncologic OutcomesMariette, ChristopheGronnier, CarolineDuhamel, AlainMabrut, Jean-YvesBail, Jean-PierreCarrere, NicolasLefevre, Jérémie H.Meunier, BernardCollet, DenisPiessen, GuillaumeBackground Self-expanding metallic stents (SEMSs) have been used as a bridge to surgery, relieving dysphagia and maintaining nutrition, in patients with operable but obstructive esophageal cancer (EC). However, the impact of SEMSs on oncologic outcomes is unknown. The aim of this study was to evaluate the impact of SEMS insertion before EC surgery on oncologic outcomes. Study Design From 2000 to 2010, two thousand nine hundred and forty-four patients who underwent an operation for EC with a curative intent were included in a multicenter European cohort. Through propensity score analysis, patients who underwent SEMS insertion (SEMS group, n = 38) were matched 1:4 to control patients who did not undergo SEMS insertion (control group, n = 152). Results The SEMS and control groups were comparable according to age, sex, tumor location, clinical stage, American Society of Anesthesiologists score, dysphagia, malnutrition, neoadjuvant treatment administration, histology, and surgical procedure. Self-expanding metallic stent insertion was complicated by tumoral perforation in 2 patients. The in-hospital postoperative mortality and morbidity rates for the SEMS vs control groups were 13.2% vs 8.6% (p = 0.370) and 63.2% vs 59.2% (p = 0.658), respectively. The R0 resection rate (71.0% vs 85.5%; p = 0.041), median time to recurrence (6.5 vs 9.0 months; p = 0.040), and 3-year overall survival (25% vs 44%; p = 0.023) were significantly reduced in the SEMS group, and the 3-year locoregional recurrence rate was increased (62% vs 34%; p = 0.049). The results remained significant after excluding SEMS-related esophageal perforations. After adjusting for confounding factors, SEMS insertion was a predictor of poor prognosis (hazard ratio = 1.6; p = 0.038). Conclusions Self-expanding metallic stent insertion, as a bridge to surgery, has a negative impact on oncologic outcomes in EC. Clinicaltrials.gov ID: NCT 01927016.PublishedChemaly, Rodrigue2022-11-04T14:27:41Z2022-11-04T14:27:41Z20152022-11-04Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1072-7515http://hdl.handle.net/10725/14216https://doi.org/10.1016/j.jamcollsurg.2014.11.028Mariette, C., Gronnier, C., Duhamel, A., Mabrut, J. Y., Bail, J. P., Carrere, N., ... & Bertrand, C. (2015). Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes. Journal of the American College of Surgeons, 220(3), 287-296.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://www.sciencedirect.com/science/article/abs/pii/S1072751514018596enJournal of the American College of Surgeonsinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/142162022-11-04T14:27:41Z |
| spellingShingle | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer Mariette, Christophe |
| status_str | publishedVersion |
| title | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| title_full | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| title_fullStr | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| title_full_unstemmed | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| title_short | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| title_sort | Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer |
| url | http://hdl.handle.net/10725/14216 https://doi.org/10.1016/j.jamcollsurg.2014.11.028 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://www.sciencedirect.com/science/article/abs/pii/S1072751514018596 |