Oesphageal stenting for palliation of malignant mesothelioma

Our plain-English summary of Oesphageal stenting for palliation of malignant mesothelioma, by E. Akowuah, J. Rahamim (Journal of Cardiothoracic Surgery, 2008).

The study

• Authors: E. Akowuah, J. Rahamim
• Journal: Journal of Cardiothoracic Surgery
• Published: 2008;3:3
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Dyspahgia in patients with malignant mesothelioma is usually due to direct infiltration of the eosophagus by the tumour. It can be distressing for the patient and challenging for the physician to treat. We describe three cases in which this condition has been successfully palliated with self expanding esophageal stents.

In plain English

This was a case report on three men with malignant pleural mesothelioma treated at Derriford Hospital in Plymouth, UK, for dysphagia (difficulty swallowing). Their mesothelioma had invaded or pressed on the oesophagus. Two of the men had a history of previous asbestos exposure; the report gave no fiber type or job details. Each had a self-expanding metal stent placed in the oesophagus, and in two cases a balloon was used to widen the stent afterwards. The first man needed a second stent about four months later when a new section narrowed. He died 8 months later without further swallowing problems. The second lived a further 6 months with no stent-related complications. The third was readmitted after one month, and a repeat endoscopy found a food blockage inside the stent, which was still widely open; the food blockage was removed. He survived a further month. The authors reported that all three men gained weight after stenting. They concluded that active treatment of dysphagia in mesothelioma benefits patients even when the disease has spread, and should be considered in all cases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (series of three patients)
• Who was studied: Three men, aged 79, 67 and 68, with malignant pleural mesothelioma (two epithelioid type, one sarcomatoid) who developed dysphagia. They were treated at Derriford Hospital, Plymouth, UK, with diagnoses between 2000 and 2005.
• Exposure: Patients 1 and 2 had a history of previous asbestos exposure. No fiber type, job or dose was given, and asbestos exposure is not mentioned for patient 3. The treatment studied was endoscopic placement of self-expanding metal stents in the oesophagus, with balloon dilatation in two cases.
• Main results:
  • Patient 1 had a 15 cm stent with balloon dilatation for narrowing from 15 to 30 cm. After 4 months a new narrowing below the stent needed a second stent. He died 8 months later without further dysphagia.
  • Patient 2 (sarcomatoid mesothelioma) had a 10 cm stent for compression from 30 to 40 cm. He survived a further 6 months with a good level of activity and no stent-related complications.
  • Patient 3 was readmitted 1 month after stenting. A repeat endoscopy found a food bolus obstruction inside a widely patent stent, and the obstruction was removed. He survived a further 1 month with no further stent complications.
  • The authors stated that the three patients lived 6, 8 and 2 months after stent placement.
  • All three patients gained weight after stent insertion. The authors suggested that weight loss may in part have been due to local effects of the tumour.
• The authors' conclusion: The authors concluded that active treatment of dysphagia in patients with malignant mesothelioma is beneficial even in the presence of disseminated disease, and should be considered in all cases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

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