Research Article
The Impact of Self-Expanding Metallic Stent Insertion on Survival and Oncological Outcomes in Oesophageal Cancer
Christopher C KearseyContext: Oesophageal Cancer (OC) is an aggressive malignancy which can be temporarily managed with Self-Expanding Metal Stents (SEMS) to improve patient’s dysphagia and “bridge the gap†preceding surgical resection. Aims: This study aimed to determine whether SEMS has an adverse effect on patient’s oncological outcome and mean survival time through a retrospective data analysis. Methods and Material: We retrospectively analysed 121 patients with OC who underwent curative resection between 2010 to 2015 and who underwent SEMS insertion (stent group, n=108) or not (no stent group, n=13) prior to surgical resection. Patients were then followed up in a prospective data analysis to determine survival time (months) post resection. Further analysis of oncological outcomes was performed. Statistical analysis used: Survival data was analysed using Kaplan-Meier analysis and statistical analysis included the Chi-Squared test (categorical data) and cox regression for hazard ratios. P < 0.05 was considered as significant. Results: Mean survival time was considerably higher for patients in the non-stent group compared to the stent group (1380 days vs 737 days; p=0.05). This represented a 2-fold negative predictor factor on prognosis (hazard ratio = 2.28; p=0.042). These results were comparable to those receiving incomplete resections (hazard ratio= 2.32; p=0.12) (95% CI 1.208-4.68). Conclusions: Oesophageal SEMS insertion is associated with significantly reduced mean survival time and oncological outcomes when utilised as a pre-operative ‘bridge to resection’.