Self-expanding metal stents (SEMS) for patients with advanced Esophageal cancer in Malawi: an effective palliative treatment
Background and Objectives: Esophageal cancer is common in Malawi and most patients are inoperable at time of diagnosis. The aim of this study was to prospectively evaluate palliative treatment with self-expanding metal stents (SEMS) in Malawi, a low-income country with limited medical resources. Met...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2012
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| In: |
Journal of surgical oncology
Year: 2012, Volume: 105, Issue: 4, Pages: 410-414 |
| ISSN: | 1096-9098 |
| DOI: | 10.1002/jso.23003 |
| Online Access: | Verlag, Pay-per-use, Volltext: http://dx.doi.org/10.1002/jso.23003 Verlag, Pay-per-use, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/jso.23003 
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| Author Notes: | Alexander Thumbs, Eric Borgstein, Leo Vigna, T. Peter Kingham, Adam L. Kushner, Kai Hellberg, Jane Bates, and Torsten J. Wilhelm |
| Summary: | Background and Objectives: Esophageal cancer is common in Malawi and most patients are inoperable at time of diagnosis. The aim of this study was to prospectively evaluate palliative treatment with self-expanding metal stents (SEMS) in Malawi, a low-income country with limited medical resources. Methods: Data of patients with advanced inoperable esophageal cancer were prospectively collected. Tumor and patient specifics, risk factors, dysphagia scores, complications, and survival were assessed. Follow-up data for 1 year or until death were collected from 118/143 patients (83%) during clinic visits, home visits, or via cell phone. Results: One hundred forty-three patients were treated with 154 SEMS. Median survival was 210 days (95% CI: 150-262 days). Fourteen of 118 patients with complete follow-up (11.9%) survived more than 1 year with longest documented survival of 406 days. The median dysphagia score improved from 3 at the time of presentation to 0 at the time of death. Early complications occurred in 4.2% (6/143), late complications in 11.9% of patients (14/118). The procedure related mortality was 2.1% (3/143). Conclusions: SEMS is an appropriate palliative treatment in a resource-limited environment. For the vast majority of patients a single intervention provides lasting improvement of dysphagia. |
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| Item Description: | Gesehen am 24.05.2018 Article was first published online on 12 December 2011 in the Wiley Online Library |
| Physical Description: | Online Resource |
| ISSN: | 1096-9098 |
| DOI: | 10.1002/jso.23003 |