Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer

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dc.contributor Chemaly, Rodrigue
dc.contributor.author Mariette, Christophe
dc.contributor.author Gronnier, Caroline
dc.contributor.author Duhamel, Alain
dc.contributor.author Mabrut, Jean-Yves
dc.contributor.author Bail, Jean-Pierre
dc.contributor.author Carrere, Nicolas
dc.contributor.author Lefevre, Jérémie H.
dc.contributor.author Meunier, Bernard
dc.contributor.author Collet, Denis
dc.contributor.author Piessen, Guillaume
dc.date.accessioned 2022-11-04T14:27:41Z
dc.date.available 2022-11-04T14:27:41Z
dc.date.copyright 2015 en_US
dc.date.issued 2022-11-04
dc.identifier.issn 1072-7515 en_US
dc.identifier.uri http://hdl.handle.net/10725/14216
dc.description.abstract 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. en_US
dc.language.iso en en_US
dc.title Self-Expanding Covered Metallic Stent as a Bridge to Surgery in Esophageal Cancer en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Impact on Oncologic Outcomes en_US
dc.author.school SOM en_US
dc.author.idnumber 201805037 en_US
dc.author.department N/A en_US
dc.relation.journal Journal of the American College of Surgeons en_US
dc.journal.volume 220 en_US
dc.journal.issue 3 en_US
dc.article.pages 287-296 en_US
dc.identifier.doi https://doi.org/10.1016/j.jamcollsurg.2014.11.028 en_US
dc.identifier.ctation 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. en_US
dc.author.email rodrigue.chemaly@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://www.sciencedirect.com/science/article/abs/pii/S1072751514018596 en_US
dc.note Contributors: FREGAT Working Group-FRENCH-AFC en_US
dc.orcid.id https://orcid.org/0000-0002-3670-6027 en_US
dc.author.affiliation Lebanese American University en_US

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