Self-expanding metal stents (SEMS) for patients with advanced Esophageal cancer in Malawi

• Verfasst von: Thumbs, Alexander [VerfasserIn]
• Verfasst von: Wilhelm, Torsten [VerfasserIn]
• Titel: Self-expanding metal stents (SEMS) for patients with advanced Esophageal cancer in Malawi
• Titelzusatz: an effective palliative treatment
• Verf.angabe: Alexander Thumbs, Eric Borgstein, Leo Vigna, T. Peter Kingham, Adam L. Kushner, Kai Hellberg, Jane Bates, and Torsten J. Wilhelm
• Jahr: 2012
• Umfang: 5 S.
• Fussnoten: Gesehen am 24.05.2018 ; Article was first published online on 12 December 2011 in the Wiley Online Library
• Titel Quelle: Enthalten in: Journal of surgical oncology
• Ort Quelle: Bognor Regis [u.a.] : Wiley, 1996
• Jahr Quelle: 2012
• Band/Heft Quelle: 105(2012), 4, Seite 410-414
• ISSN Quelle: 1096-9098
• DOI: doi:10.1002/jso.23003
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: esophageal carcinoma
• Sach-SW: palliation
• Sach-SW: resource-limited countries
• Sach-SW: rural Africa
• Sach-SW: stenting
• K10plus-PPN: 1575464470

Abstract

Background and Objectives: Esophageal cancer is common in Malawi and most patients are inoperable at time of diagnosis. The aim of this study was to prospectively evaluate palliative treatment with self-expanding metal stents (SEMS) in Malawi, a low-income country with limited medical resources. Methods: Data of patients with advanced inoperable esophageal cancer were prospectively collected. Tumor and patient specifics, risk factors, dysphagia scores, complications, and survival were assessed. Follow-up data for 1 year or until death were collected from 118/143 patients (83%) during clinic visits, home visits, or via cell phone. Results: One hundred forty-three patients were treated with 154 SEMS. Median survival was 210 days (95% CI: 150-262 days). Fourteen of 118 patients with complete follow-up (11.9%) survived more than 1 year with longest documented survival of 406 days. The median dysphagia score improved from 3 at the time of presentation to 0 at the time of death. Early complications occurred in 4.2% (6/143), late complications in 11.9% of patients (14/118). The procedure related mortality was 2.1% (3/143). Conclusions: SEMS is an appropriate palliative treatment in a resource-limited environment. For the vast majority of patients a single intervention provides lasting improvement of dysphagia.