Efficacy and Safety of Esophageal SEMS in Advanced Esophageal Cancer

Background: Esophageal cancer is the eighth most common cancer worldwide and constitutes the sixth leading cause of cancer deaths. Esophageal malignancies are advanced at the time of diagnosis in a large number of patients and they invariably require palliation for relief of dysphagia. Self - expandable metallic stent (SEMS) placement offers an excellent modality for palliation of dysphagia in inoperable esophageal malignancies, as well as in those whose disease recurred after different treatment modalities. It is a highly accepted method of treatment for palliation in cancer esophagus. Objective: To evaluate the safety and efficacy of esophageal stenting as a palliative therapy for dysphagia in esophageal cancer. Methods: Patients who underwent self - expandable metallic stent (SEMS) placement for relief of dysphagia in esophageal cancer were retrospectively recruited into the study in a consecutive manner. Stents from different manufacturers were used. Efficacy of the self - expandable metallic stent (SEMS) placement in terms of improvement in dysphagia score and adverse events were analyzed. Results: Esophageal SEMS placement was performed in 42 patients (median age 62 years; 48% men); 18 (43%) were diagnosed with adenocarcinoma and 24 (57%) with squamous cell carcinoma. Median dysphagia score improved from 3.45 ? 0.5 to 1.40 ? 0.58 after esophageal SEMS placement. Overall 12/42 (28.5%) of patients experienced complications. Most common complication was stent migration in 6 (14%) patients. Conclusion: SEMS is an effective therapy for relief of dysphagia in patients with esophageal carcinoma. Although certain complications like stent migration and tumor ingrowth are seen with SEMS placement, they can be easily managed.