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. 2016 Apr 25;7(7):794-802.
doi: 10.7150/jca.15097. eCollection 2016.

Survival and Quality of Life Benefit after Endoscopic Management of Malignant Central Airway Obstruction

Grigoris Stratakos  1 , Vasiliki Gerovasili  2 , Charalampos Dimitropoulos  1 , Ioannis Giozos  3 , Filippos T Filippidis  2 , Sofia Gennimata  1 , Paul Zarogoulidis  4 , Athanasios Zissimopoulos  5 , Athanasia Pataka  4 , Nikos Koufos  1 , Spyros Zakynthinos  2 , Konstantinos Syrigos  3 , Nikos Koulouris  1
Affiliations

Survival and Quality of Life Benefit after Endoscopic Management of Malignant Central Airway Obstruction

Grigoris Stratakos et al. J Cancer. .

Abstract

Background: Although interventional management of malignant central airway obstruction (mCAO) is well established, its impact on survival and quality of life (QoL) has not been extensively studied.

Aim: We prospectively assessed survival, QoL and dyspnea (using validated EORTC questionnaire) in patients with mCAO 1 day before interventional bronchoscopy, 1 week after and every following month, in comparison to patients who declined this approach. Material/Patients/Methods: 36 patients underwent extensive interventional bronchoscopic management as indicated, whereas 12 declined. All patients received full chemotherapy and radiotherapy as indicated. Patients of the 2 groups were matched for age, comorbidities, type of malignancy and level of obstruction. Follow up time was 8.0±8.7 (range 1-38) months.

Results: Mean survival for intervention and control group was 10±9 and 4±3 months respectively (p=0.04). QoL improved significantly in intervention group patients up to the 6(th) month (p<0.05) not deteriorating for those surviving up to 12 months. Dyspnea decreased in patients of the intervention group 1 month post procedure remaining reduced for survivors over the 12th month. Patients of the control group had worse QoL and dyspnea in all time points.

Conclusions: Interventional management of patients with mCAO, may achieve prolonged survival with sustained significant improvement of QoL and dyspnea.

Keywords: intervention; lung cancer; quality of life..

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Conflict of interest statement

Conflict of Interest: None to declare.

Figures

Figure 1
Figure 1
Kaplan Meier curves showing survival after diagnosis of airway obstruction in patients of the intervention group as compared to the control group.
Figure 2
Figure 2
Global QoL (QL2), Physical function (PF2) and Level of Dyspnea (DY) assessed with the EORTC questionnaire in patients of the intervention group in comparison to the control group. (Error bars represent mean   ±  2SE).
Figure 3
Figure 3
Argon Plasma Coagulation.
Figure 4
Figure 4
LASER beam coagulation.
Figure 5
Figure 5
Cryoprobe performing debulking of central airways malignnat tumor.
Figure 6
Figure 6
Bifurcated silicone stent.
Figure 7
Figure 7
Rigid electrocatery.
Figure 8
Figure 8
Removal of endobronchial tumor with loop.
See this image and copyright information in PMC

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