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Malignant esophagorespiratory fistulas: a comparative effectiveness survival analysis
Irfan Ahmad1, Kundan Singh Chufal2, Ram Bajpai3
1Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India irfan.a@icloud.com.
Survival for patients with malignant esophagorespiratory fistulas (ERF) is poor. Our study found that best supportive care offers survival outcomes equivalent to invasive interventions for ERF patients.
Area of Science:
- Oncology
- Gastroenterology
- Thoracic Surgery
Background:
- Malignant esophagorespiratory fistulas (ERF) significantly complicate cancer treatment and patient prognosis.
- Limited data exists on comparative survival outcomes for ERF-directed interventions.
Purpose of the Study:
- To analyze survival in patients diagnosed with malignant ERF.
- To conduct a comparative effectiveness analysis of interventions for ERF.
Main Methods:
- Retrospective analysis of 55 patients with malignant ERF.
- Data collected on interventions: stent placement, surgical repair, and best supportive care.
- Primary endpoints: overall survival (OS) and survival after ERF diagnosis (F-OS).
Main Results:
- Median OS was 299 days; median F-OS was 123 days.
- AJCC stage IV, distal ERF location, and developing ERF late ( >3 months) were associated with poorer F-OS.
- Best supportive care demonstrated statistically equivalent OS and F-OS compared to active interventions.
Conclusions:
- Survival for patients with malignant ERF is generally dismal.
- Best supportive care provides comparable survival outcomes to interventions for ERF.
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