IDDF2021-ABS-0129 Metallic stent insertion for palliation of esophageal cancer: single-centre experience from Saudi Arabia

Background The use of Self-Expandable metallic stents (SEMS) as a non-surgical alternative for palliation of advanced esophageal cancer (EC) is increasing. However, there is a scarcity of real-life experience on the use of these stents exclusively in oesophageal cancer. The aim of this study is to evaluate the efficacy of SEMS in inoperable esophageal cancers in the western region of Saudi Arabia. Methods A retrospective review of SEMS placed in a tertiary referral hospital for histological proven inoperable EC from 2012 until 2015. Demographics data, procedure success, complication, re-intervention and mortality were analyzed. Results 46 SEMS were placed in 35 patients for palliation of dysphagia. Median age of patients was 68 years (range 31 - 95). 69% (24) patients have lower third of EC and the rest have middle third (IDDF2021-ABS-0129 Table 1). SEMS was placed successfully in all cases with symptomatic improvement. No major stent-related complication seen. 28% (13) patients required re-intervention with additional SEMS placement, 9 of which were for tissue in growth and 4 for distal migration. Median survival was 114 days (range 30 – 498). Most of the complications seen in fully covered SEMS compared to the partially covered 50% (8/16) vs 17% (5/30), respectively p = 0.04 (IDDF2021-ABS-0129 Table 2). Chemo and/or radiotherapy were given to 51% (18) of the patients without any significant benefit on survival (p = 0.79) or re-intervention rate (p = 0.47) compared to those who did not. Conclusions SEMS is effective in palliating dysphagia in inoperable EC without major complications. Rates of tumor in-growth and migration were comparable to other studies. SEMS provides long-term palliation.