Johannes Routila1,2, Eino Herhi1, Jarkko Korpi3, Jaakko Pulkkinen1,2, Petri Koivunen3, Jami Rekola1,2. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland. 2. Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku, Turku, Finland. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.
Abstract
OBJECTIVES: Tracheobronchial stenting has an established role in the palliation of malignant central airway obstruction (CAO). The purpose of this study is to describe the experience with self-expanding metal airway stents in 2 tertiary referral centres, covering a third of the population of Finland. METHODS: Patients referred to and treated with airway stenting for malignant CAO using self-expanding metal-stents were identified from electronic patient records, and data were collected using a structured Endoscopic Lower Airway Management instrument. Statistical analysis to reveal factors affecting patient benefit and survival was carried out. RESULTS: A total of 101 patients (mean age 65.8) and 116 procedures were identified. Procedure-related mortality was rare (3/101 patients) and complications infrequent. The median survival was 2.3 months [95% confidence interval (CI): 1.4-3.1). Stent benefit was not significantly affected by clinical characteristics. Survival was impacted by the use of adjunct procedures [hazard ratio (HR) 0.36, 95% CI: 0.23-0.58, P < 0.001), procedural urgency (HR 0.40; 95% CI: 0.23-0.71, P = 0.002) and post-treatment chemoradiotherapy (HR 0.29, 95% CI: 0.15-0.56, P < 0.001). CONCLUSIONS: The beneficial impact observed supports the further use of tracheobronchial stenting in malignant CAO. The use of self-expanding metal stents is encouraged.
OBJECTIVES: Tracheobronchial stenting has an established role in the palliation of malignant central airway obstruction (CAO). The purpose of this study is to describe the experience with self-expanding metal airway stents in 2 tertiary referral centres, covering a third of the population of Finland. METHODS: Patients referred to and treated with airway stenting for malignant CAO using self-expanding metal-stents were identified from electronic patient records, and data were collected using a structured Endoscopic Lower Airway Management instrument. Statistical analysis to reveal factors affecting patient benefit and survival was carried out. RESULTS: A total of 101 patients (mean age 65.8) and 116 procedures were identified. Procedure-related mortality was rare (3/101 patients) and complications infrequent. The median survival was 2.3 months [95% confidence interval (CI): 1.4-3.1). Stent benefit was not significantly affected by clinical characteristics. Survival was impacted by the use of adjunct procedures [hazard ratio (HR) 0.36, 95% CI: 0.23-0.58, P < 0.001), procedural urgency (HR 0.40; 95% CI: 0.23-0.71, P = 0.002) and post-treatment chemoradiotherapy (HR 0.29, 95% CI: 0.15-0.56, P < 0.001). CONCLUSIONS: The beneficial impact observed supports the further use of tracheobronchial stenting in malignant CAO. The use of self-expanding metal stents is encouraged.
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