Preview

Grekov's Bulletin of Surgery

Advanced search

Esophageal stenting for unresectable cancer (review of literature)

https://doi.org/10.24884/0042-4625-2020-179-5-113-119

Abstract

To date, the main way to stop dysphagia for patients with unresectable esophageal cancer is stenting. Being widely accepted and effective, this technique, however, allows for oral nutrition only for an average of 3–4 months and is accompanied by the development of a wide range of complications. Recent Russian and foreign publications in the field show that evaluation of the effectiveness of the stenting technique, including analysis of possibility of complications development, is important for practical application. To improve long-term outcomes, the potential trends in the method evolution have already been identified. The stents coated with radioactive isotopes of iodine are among of the actively used novelties. Application of 3D printing for the manufacture of custom-tailored stents, as well as the inclusion of chemotherapeutic agents in the coating of self-expanding metal stents seem promising approach. The search for a «perfect stent» continues under paradigm of personalization.

About the Authors

N. S. Popova
Saint-Petersburg clinical scientific and practical center for specialized types of medical care (oncological)
Russian Federation

Doctor of the Department of Endoscopy, 

Saint Petersburg



A. A. Avanesyan
Saint-Petersburg clinical scientific and practical center for specialized types of medical care (oncological)
Russian Federation

Cand. of Sci. (Med.), Head of the Department of Endoscopy,

Saint Petersburg



B. I. Miroshnikov
Saint-Petersburg clinical scientific and practical center for specialized types of medical care (oncological)
Russian Federation

Dr. of Sci. (Med.), Surgery Expert, 

Saint Petersburg



V. M. Moiseenko
Saint-Petersburg clinical scientific and practical center for specialized types of medical care (oncological)
Russian Federation

Dr. of Sci. (Med.), Professor, Chief, 

Saint Petersburg



References

1. Mocanu A. et al. Endoscopic palliation of advanced esophageal cancer. J. Med. Life. 2015;8(2):193–201.

2. Kaprin A. D. Zlokachestvennye novoobrazovaniya v Rossii v 2018 godu (zabolevaemost’ i smertnost’). Ed. A. D. Kaprin, V. V. Starinskij, G. V. Petrova. Moscow, 2019:250. (In Russ.).

3. Axel E. M. Gastrointestinal cancer statistics. Siberian journal of oncology. 2017;16(3):5–11. (In Russ.). Doi: 10.21294/1814-4861-2017-3-5-11.

4. Ohkura Y. et al. Clinicopathologic Characteristics of Oligometastases from Esophageal Cancer and Long-Term Outcomes of Resection. Ann. Surg. Oncol. 2020.

5. Drobyazgin E. A., Chikinev Yu. V., Anikeeva O. Yu., Polovnikov E. S., Kudryavcev A. S. Oshibki i oslozhneniya stentirovaniya pishchevoda i pishchevodnyh anastomozov. Vestnik FGBU “RONC im. N. N. Blohina”. 2016;27(2):99–102.

6. Drobyazgin E. A., Chikinev Yu. V., Sudovykh I. E., Anikina M. S. Tracheoesophageal stenting in their tumor stenosis. Grekov’s Bulletin of Surgery. 2016;175(1):74–77. (In Russ.). Doi: 10.24884/0042-4625-2016-175-1-74-77.

7. Runge T., Baron T. H. Palliative Treatment of Esophageal Cancer // Esophageal Cancer. 2018:181–191.

8. Lai A. et al. Role of Esophageal Metal Stents Placement and Combination Therapy in Inoperable Esophageal Carcinoma: A Systematic Review and Meta-analysis. Dig. Dis. Sci. 2018.

9. Shah T. et al. Neoadjuvant cryotherapy improves dysphagia and may impact remission rates in advanced esophageal cancer. Endosc. Int. Open. 2019;07(11):E1522–E1527.

10. Frimberger E. Expanding Spiral – A New Type of Prosthesis for the Palliative Treatment of Malignant Esophageal Stenoses. Endoscopy. 1983.

11. Jain P. Self-expanding metallic esophageal stents: A long way to go before a particular stent can be recommended. World J. Gastroenterol. 2011;17(48):5327–5328.

12. Kujawski K., Stasiak M., Rysz J. The evaluation of esophageal stenting complications in palliative treatment of dysphagia related to esophageal cancer. Med. Sci. Monit. 2012;18(5):CR323–9.

13. Kim K. Y. et al. Self-expandable metallic stent placement for the palliation of esophageal cancer. Journal of Korean Medical Science. 2017;32(7):1062–1071.

14. Na H. K. et al. How to design the optimal self-expandable oesophageal metallic stents: 22 years of experience in 645 patients with malignant strictures. Eur. Radiol. 2013;23(3):786–796.

15. Verschuur E. M. L. et al. New design esophageal stents for the palliation of dysphagia from esophageal or gastric cardia cancer: a randomized trial. Am. J. Gastroenterol. 2008;103(2):304–312.

16. Siddiqui A. A. et al. Expandable polyester silicon-covered stent for malignant esophageal strictures before neoadjuvant chemoradiation: a pilot study. Dig. Dis. Sci. 2007;52(3):823–829.

17. Fiorelli A. et al. Large tracheobronchial fistula due to esophageal stent migration: Let it be! Asian Cardiovasc. Thorac. Ann. 2015;23(9): 1106–1109.

18. Holm A. N. et al. Self-expanding plastic stents in treatment of benign esophageal conditions. Gastrointest. Endosc. 2008.

19. Spaander M. C. W. et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016;48(10):939–948.

20. Touchefeu Y. et al. Chemotherapy versus self-expanding metal stent as primary treatment of severe dysphagia from unresectable oesophageal or gastro-oesophageal junction cancer. Dig. Liver Dis. 2014.

21. Uesato M. et al. Comparison of Efficacy of Self-Expandable Metallic Stent Placement in the Unresectable Esophageal Cancer Patients. Gastroenterol. Res. Pract. 2017;2017.

22. Heller S. J. et al. Management of bleeding GI tumors. Gastrointestinal Endoscopy. 2010;72(4):817–824.

23. Akhtar K. et al. Argon beam plasma coagulation in the management of cancers of the esophagus and stomach. Surg. Endosc. 2000; 14(12):1127–1130.

24. Chang M. A., Savides T. J. Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding. Gastrointest. Endosc. Clin. N. Am. 2018;28(3):291–306.

25. So H. et al. Efficacy and Safety of Fully Covered Self-Expanding Metal Stents for Malignant Esophageal Obstruction. Dig. Dis. Sci. 2018; 63(1):234–241.

26. Persson J. et al. Fully covered stents are similar to semi-covered stents with regard to migration in palliative treatment of malignant strictures of the esophagus and gastric cardia: results of a randomized controlled trial. Surg. Endosc. 2017;31(10):4025–4033.

27. Vanbiervliet G. et al. The role of clips in preventing migration of fully covered metallic esophageal stents: a pilot comparative study. Surg. Endosc. 2012;26(1):53–59.

28. Yang J. et al. Esophageal stent fixation with endoscopic suturing device improves clinical outcomes and reduces complications in patients with locally advanced esophageal cancer prior to neoadjuvant therapy: a large multicenter experience. Surg. Endosc. 2017;31(3):1414–1419.

29. Francis S. R. et al. Toxicity and Outcomes in Patients With and Without Esophageal Stents in Locally Advanced Esophageal Cancer. Int. J. Radiat. Oncol. Biol. Phys. 2017;99(4):884–894.

30. Reijm A. et al. Early pain detection and management after esophageal metal stent placement in incurable cancer patients: A prospective observational cohort study. Endosc. Int. Open. 2016;04(08):E890–E894.

31. White R. E. et al. Randomized trial of small-diameter versus largediameter esophageal stents for palliation of malignant esophageal obstruction. J. Clin. Gastroenterol. 2015;49(8):660–665.

32. Rueth N. M. et al. Esophageal stenting and radiotherapy: a multimodal approach for the palliation of symptomatic malignant dysphagia. Ann. Surg. Oncol. 2012;19(13):4223–4228.

33. Eldeeb H., El-Hadaad H. A. Radiotherapy versus stenting in treating malignant dysphagia. J. Gastrointest. Oncol. 2012;3(4):322–325.

34. Kim J. Y. et al. Clinical outcomes of esophageal stents in patients with malignant esophageal obstruction according to palliative additional treatment. J. Dig. Dis. 2015;16(10):575–584.

35. Roseira J. et al. Utility of stent double palliation for esophageal cancer with airway involvement: the extremis of care. Dis. esophagus. 2019.

36. Mão-de-Ferro S. et al. Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status. Eur. J. Clin. Nutr. 2016;70(3):409–410.

37. Tham J. E. et al. Oesophageal Stents for Potentially Curable Oesophageal Cancer – A Bridge to Surgery? Ulster Med. J. 2019;88(1):10–14.

38. Mariette C. et al. Self-expanding covered metallic stent as a bridge to surgery in esophageal cancer: impact on oncologic outcomes. J. Am. Coll. Surg. 2015;220(3):287–296.

39. Joshi M., Gadahire M., Paranjape A., Kamble R., Pawar V., Ansari K., JainA., Patel R. D. A combination of self-expansile metallic stent and external beam radiotherapy in management of advanced esophageal carcinoma with grade iii dysphagia and beyond. J. Dig. Endosc. 2018;9(2):61–65.

40. Francis S. R. et al. Self-expanding stent effects on radiation dosimetry in esophageal cancer. J. Appl. Clin. Med. Phys. 2013.

41. Ramakrishnaiah V. P. N. et al. Palliation of Dysphagia in Carcinoma Esophagus. Clin. Med. Insights. Gastroenterol. 2016;9:11–23.

42. Lin M. et al. 3D-printed flexible polymer stents for potential applications in inoperable esophageal malignancies. Acta Biomater. 2019;83:119–129.

43. Chen H.-L., Shen W.-Q., Liu K. Radioactive self-expanding stents for palliative management of unresectable esophageal cancer: a systematic review and meta-analysis. Dis. esophagus. 2017;30(5):1–16.

44. Bi Y. et al. Modified Type of Double-Covered Self-Expandable Segmental Metallic Stents for Palliation of Esophageal Fistula. J. Laparoendosc. Adv. Surg. Tech. 2019;29(7):875–879.

45. Tokar J. L. et al. Drug-eluting/biodegradable stents. Gastrointest. Endosc. 2011;74(5):954–958.

46. Shaikh M. et al. Engineering Stent Based Delivery System for Esophageal Cancer Using Docetaxel. Mol. Pharm. 2015;12(7):2305–2317.

47. Zhang Y. et al. The effect of paclitaxel-eluting covered metal stents versus covered metal stents in a rabbit esophageal squamous carcinoma model. PLoS One. 2017;12(3):e0173262.

48. Guo S. R. et al. In vivo evaluation of 5-fluorouracil-containing selfexpandable nitinol stent in rabbits: Efficiency in long-term local drug delivery. J. Pharm. Sci. 2010;99(7):3009–3018.

49. Wang Z. et al. Nitinol stents loaded with a high dose of antitumor 5-fluorouracil or paclitaxel: esophageal tissue responses in a porcine model. Gastrointest. Endosc. 2015;82(1):153-160.e1.

50. Lee J. W., Yang S.-G., Na K. Gemcitabine-releasing polymeric films for covered self-expandable metallic stent in treatment of gastrointestinal cancer. Int. J. Pharm. 2012;427(2):276–283.


Supplementary files

Review

For citations:


Popova N.S., Avanesyan A.A., Miroshnikov B.I., Moiseenko V.M. Esophageal stenting for unresectable cancer (review of literature). Grekov's Bulletin of Surgery. 2020;179(5):113-119. (In Russ.) https://doi.org/10.24884/0042-4625-2020-179-5-113-119

Views: 793


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)