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  P2.04 - Poster Session with Presenters Present (ID 466)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17779

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    P2.04-051 - Palliative Treatment of Dysphagia Syndrome in Patients with Gastroesophageal Cancer (ID 5014)

    14:30 - 14:30  |  Author(s): A.V. Kasatov
    • Abstract

    Background:
    Cancer of esophagus and cardia takes the 7th place in the structure of oncological diseases in Russia and the 3rd place among tumors of gastrointestinal tract. Despite the development of modern methods of diagnosis, esophageal cancer is often detected only when a clear obstruction of the esophagus happens, in stages IIIB and IV. Distant metastasis and the advance of cancer at the moment of diagnoses make it impossible to provide definitive therapy. In this case, therapy which is aimed to reduce the esophagus obstruction becomes particularly relevant. The surgical approach also remains relevant, either the open surgery specifically gastrostomy including endoscopic one or endoprosthesis of esophagus with intraluminal stenting is preferable.
    
    Methods:
    In total 167 patients with dysphagia complaints of different severity were hospitalized to the department of Thoracic Surgery of Perm Regional Clinical Hospital during the period of 2013-2015. In 57.9% cases (96 patients) the esophageal squamous cell cancer was the reason of dysphagia, and in 42.1% cases (71 patients) it was adenocarcinoma of cardia with junction to lower third of esophagus. The patient’s mean age was 62.8 years.
    
    Results:
    Aphagia was revealed in 18.5% cases and 78.2% of patients could only drink. All patients reported a decrease in body weight due to malnutrition.Stages IIIB and IV cancer were diagnosed in 118 (70.7%). Endoscopic gullet bougienage with intraluminal self-expanding stenting was performed in 122 patients. Four patients with IIB and IIIA stages of esophagus cancer had the stents because of the severe comorbidity that disables definitive surgical treatment. In 28 patients (22.9%) the migration of the stent was diagnosed, in 10 of them (8.1%) the re-stenting was required later; in the remaining 18 patients the correction during the first day after stenting was enough. All patients declared a decrease in dysphagia starting from the 2nd day after stenting. The absence of dysphagia at time of hospital discharge was reveled in 82.9% cases. Mean life span of patients after stenting was 9.58 months.Only in 1 case (0.8%) the cardia cancer bleeding was diagnosed 3 days after stenting and one patient (0.8%) with the bougienage of tumor and stenting had complication in form of esophageal perforation. The mean duration of hospitalization was 7.6 days.
    
    Conclusion:
    Therefore, esophageal endoprosthesis is a highly effective, minimally invasive treatment for dysphagia in incurable oncologic patients with dysphagia that makes self-enteral feeding capable, provides adequate nutritional support, and significantly improves the quality of life.