The Efficacy of Esophageal Stenting in Managing Esophageal Tumor Perforation: A Retrospective Study

Esophageal tumor perforation is a serious complication, seen in patients undergoing chemo-radiotherapy for advanced-stage cancer, and can lead to life-threatening conditions like sepsis and empyema. Esophageal stenting with self-expandable metal stents offers a safer, less invasive alternative to surgery, helping restore oral intake and improve patient comfort. This study aims to determine the effectiveness of esophageal stenting in managing esophageal tumor perforation at different disease stages and to assess long-term outcomes.

This retrospective cohort study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center in Peshawar by reviewing 600 patient records presenting with esophageal tumor perforation from January 2016 to December 2021, and retracted between October and December 2024. Eighty patients who underwent esophageal stenting were enrolled in the study. Data on demographics, tumor characteristics, treatment history, and survival status were collected from the hospital's electronic system. SPSS-25 was used for analysis purposes. The chi-square test was employed to determine statistical significance (p ≤ 0.05).

The mean age of patients was 46.98±11.62 years, and most patients were male (45, 56.3%). Squamous cell carcinoma was the most prevalent histological type, accounting for 74(92.5%) of cases. Advanced-stage disease was observed in the majority of cases, with T3 at 48 (60.5%) and T4 at 15 (18.8%). Additionally, 34(42.5%) exhibited nodal involvement (N1 and N2 each) and 23(28.7%) had metastatic. The median stent insertion during the study period was 83 days, with a range from 1 day to 7 years. Survival status was suboptimal, with 76(95%) deceased, 4(5%) surviving. Kaplan-Meier analysis demonstrates a median survival of 200 days.

Esophageal stenting is an effective palliative intervention for managing tumor-induced esophageal perforation, particularly in patients with advanced disease, and prolongs survival.