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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Main Author: Mariette, Christophe (author)
Other Authors: Gronnier, Caroline (author), Duhamel, Alain (author), Mabrut, Jean-Yves (author), Bail, Jean-Pierre (author), Carrere, Nicolas (author), Lefevre, Jérémie H. (author), Meunier, Bernard (author), Collet, Denis (author), Piessen, Guillaume (author)
Format: article
Published: 2015
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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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
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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