Oesophageal Stents for Potentially Curable Oesophageal Cancer - A Bridge to Surgery?

Abstract

For oesophageal cancer patients with potentially curative disease, treatment usually comprises neoadjuvant chemoradiotherapy followed by surgery. Several methods are currently used for nutritional support while patients are undergoing neoadjuvant treatment but these do not relieve dysphagia. Stenting as a bridge to curative surgery has been explored in several case series and a case control study. This is a review of the current literature on the topic. Some small series have shown it to be safe and effective in relieving dysphagia and malnutrition without adverse effect on surgical outcomes, perioperative complications or delay in surgical resection post neoadjuvant therapy. However, there are sufficient concerns about its adverse impact on oncological outcomes such as a reduction in the R0 resection rates, median time to recurrence and 2 - 3 year overall survival, to not currently recommend its routine use in resectable cancers.