Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula

Fu Tsai Chung, Horng Chyuan Lin, Chun Liang Chou, Hao Cheng Chen, Chih Hsi Kuo, Chih Teng Yu, Shu Min Lin, Han Pin Kuo

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction: Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer. Methods: In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study. Results: From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95% confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95% CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95% CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95% CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95% CI, 0.03-0.59) remained as significant factors that impacted survival. Conclusions:Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.

Original languageEnglish
Pages (from-to)105-109
Number of pages5
JournalAmerican Journal of the Medical Sciences
Volume344
Issue number2
DOIs
Publication statusPublished - Aug 1 2012
Externally publishedYes

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Esophageal Neoplasms
Fistula
Survival
Confidence Intervals
Odds Ratio
Bronchoscopy
Pneumonia
Demography
Case-Control Studies
Therapeutics
Logistic Models

Keywords

  • Airway Ultraflex stents
  • Esophageal cancer
  • Esophagorespiratory fistula
  • Outcomes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula. / Chung, Fu Tsai; Lin, Horng Chyuan; Chou, Chun Liang; Chen, Hao Cheng; Kuo, Chih Hsi; Yu, Chih Teng; Lin, Shu Min; Kuo, Han Pin.

In: American Journal of the Medical Sciences, Vol. 344, No. 2, 01.08.2012, p. 105-109.

Research output: Contribution to journalArticle

Chung, Fu Tsai ; Lin, Horng Chyuan ; Chou, Chun Liang ; Chen, Hao Cheng ; Kuo, Chih Hsi ; Yu, Chih Teng ; Lin, Shu Min ; Kuo, Han Pin. / Airway ultraflex stenting in esophageal cancer with esophagorespiratory fistula. In: American Journal of the Medical Sciences. 2012 ; Vol. 344, No. 2. pp. 105-109.
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abstract = "Introduction: Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer. Methods: In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study. Results: From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95{\%} confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95{\%} CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95{\%} CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95{\%} CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95{\%} CI, 0.03-0.59) remained as significant factors that impacted survival. Conclusions:Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.",
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AU - Kuo, Chih Hsi

AU - Yu, Chih Teng

AU - Lin, Shu Min

AU - Kuo, Han Pin

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N2 - Introduction: Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer. Methods: In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study. Results: From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95% confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95% CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95% CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95% CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95% CI, 0.03-0.59) remained as significant factors that impacted survival. Conclusions:Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.

AB - Introduction: Esophagorespiratory fistula (ERF) caused by esophageal cancer has a poor prognosis. This study describes the clinical effects of airway ultraflex stenting as an alternative method for ERF caused by esophageal cancer. Methods: In an university-affiliated hospital, consecutive patients with ERF caused by esophageal cancer and confirmed by bronchoscopy were included. The demography, clinical manifestations and survival between groups with and without airway stenting were compared by case-control study. Results: From 2001 to 2007, 817 patients with esophageal cancer received bronchoscopy. Among these patients, 59 patients with ERF were included in this study. The demography and clinical manifestations between groups with and without airway stenting were similar, but survival improved in group with airway stenting, which was compared using log-rank test [P = 0.04; hazard ratio, 0.56; 95% confidence interval (CI), 0.31-0.99]. After adjusted with age and gender by multinominal logistic regression, airway stenting [adjusted odds ratio (OR), 5.2; P = 0.01; 95% CI, 1.4-18.8], performance status (adjusted OR, 6.1; P = 0.004; 95% CI, 1.8-20.8), further treatment (adjusted OR, 8.7; P = 0.001; 95% CI, 2.3-32.8) and prolonged pneumonia (adjusted OR, 0.14; P = 0.008; 95% CI, 0.03-0.59) remained as significant factors that impacted survival. Conclusions:Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival.

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