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Article

What Is the Optimal Management of Dysphagia in Metastatic Esophageal Cancer?

1
Division of Thoracic Surgery, McGill University, The Montreal General Hospital, Montreal, QC, Canada
2
Division of Radiation Oncology, McGill University, The Montreal General Hospital, Montreal, QC, Canada
3
Division of Gastroenterology, McGill University, The Montreal General Hospital, Montreal, QC, Canada
4
Department of Oncology, McGill University, The Montreal General Hospital, Montreal, QC, Canada
*
Author to whom correspondence should be addressed.
These authors contributed equally to the present work.
Curr. Oncol. 2012, 19(2), 60-66; https://doi.org/10.3747/co.19.892
Received: 6 January 2012 / Revised: 4 February 2012 / Accepted: 2 March 2012 / Published: 1 April 2012
Background: The palliation of dysphagia in metastatic esophageal cancer remains a challenge, and the optimal approach for this difficult clinical scenario is not clear. We therefore sought to define and determine the efficacy of various treatment options used at our institution for this condition. Methods: We reviewed a prospective database for all patients managed in an esophageal cancer referral centre over a 5-year period. All patients receiving palliation of malignant dysphagia were reviewed for demographics, palliative treatment modalities, complications, and dysphagia scores (0 = none to 4 = complete). The Wilcoxon signed rank test was used to determine significance (p < 0.05). Results: During 2004–2009, 63 patients with inoperable esophageal cancer were treated for palliation of dysphagia. The primary treatment was radiotherapy in 79% (brachytherapy in 18 of 50; external-beam in 10 of 50; both types in 22 of 50), and stenting in 21%. Mean wait time from diagnosis to treatment was 22 days in the stent group and 54 days in the radiotherapy group (p = 0.003). Mean duration of treatment was 1 day in the stent group and 40 days in the radiotherapy group (p = 0.001). In patients treated initially by stenting, dysphagia improved within 2 weeks of treatment in 85% of patients (dysphagia score of 0 or 1). However, 20% of patients presented with recurrence of dysphagia at 10 weeks of treatment. In the radiotherapy group, the onset of palliation was slower, with only 50% of patients palliated at 2 weeks (dysphagia score of 0 or 1). However, long-term palliation was more satisfactory, with 90% of patients remaining palliated after 10 weeks of treatment.
Keywords: esophageal cancer; palliation; stents; radiation therapy esophageal cancer; palliation; stents; radiation therapy
MDPI and ACS Style

Hanna, W.C.; Sudarshan, M.; Roberge, D.; David, M.; Waschke, K.A.; Mayrand, S.; Alcindor, T.; Ferri, L.E. What Is the Optimal Management of Dysphagia in Metastatic Esophageal Cancer? Curr. Oncol. 2012, 19, 60-66. https://doi.org/10.3747/co.19.892

AMA Style

Hanna WC, Sudarshan M, Roberge D, David M, Waschke KA, Mayrand S, Alcindor T, Ferri LE. What Is the Optimal Management of Dysphagia in Metastatic Esophageal Cancer? Current Oncology. 2012; 19(2):60-66. https://doi.org/10.3747/co.19.892

Chicago/Turabian Style

Hanna, W.C., M. Sudarshan, D. Roberge, M. David, K.A. Waschke, S. Mayrand, T. Alcindor, and L.E. Ferri. 2012. "What Is the Optimal Management of Dysphagia in Metastatic Esophageal Cancer?" Current Oncology 19, no. 2: 60-66. https://doi.org/10.3747/co.19.892

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