Palliation of Esophageal Cancer with Self-Expanding Metal Stents (SEMS): The Impact on Quality of Life

Aldenir Fresca , Wagner Colaiacovo, Pedro Luiz Toledo de Arruda Lourencao ,Gilberto Fava, Lincoln Eduardo Villela Vieira de Castro Ferreira, Alaor Caetano, Silke Anna Theresa Weber, Erika Veruska Paiva Ortolan

PURPOSE: To report the impact of self-expanding metal stents (SEMS) on the quality of life of patients with advanced esophageal cancer. METHODS: 50 patients with advanced inoperable esophageal cancer (EC) underwent palliative esophageal SEMS. Quality of life was evaluated using a cancer specific questionnaire (EORTC QLQ C-30), the Karnofsky performance scale and a dysphagia score. All questionnaires were completed prior to stent placement, 24 hours after SEMS, 7, 60 and 120 days later. All analyses were performed on an intention-to-treat basis. RESULTS: Stent placement was technically successful in all patients. Mean survival time was 144 ± 138 days (12-663 days). Dysphagia score improved significantly from 3.6 ± 0.4 before stent placement to 2.7±0.5 after 24 hours, 2.0 ± 0.2 at one week, 1.8 ± 0.4 at 2 months, and 2.5 ± 0.5 at 4 months (p<0.0001). A significant improvement in Karnofsky index was seen 7 days after SEMS. In the EORTC QLQ C-30 questionnaire, differences were detected in questions 19, 26, 27, 29 and 30. CONCLUSION: The use of SEMS in patients with inoperable esophageal cancer had a positive impact on patient’s quality of life, measured by different methods, being a good choice as a palliative treatment.