Stent insertion for malignant superior vena cava syndrome: effectiveness and long-term outcome
Stent insertion for malignant superior vena cava syndrome: effectiveness and long-term outcome
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DOI：
10.1007/s11547-017-0767-1
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发表时间：
2017-08-01
影响因子：
8.9
通讯作者：
Cao, Chi
中科院分区：
文献类型：
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作者：
Niu, Su;Xu, Yuan-Shun;Cao, Chi
目的探讨恶性上级腔静脉综合征（SVC）支架置入术的临床疗效及远期疗效。回顾性分析技术成功率、临床成功率和远期疗效。结果所有患者均成功置入SVC支架。共使用了65枚支架。无手术相关并发症发生。平均SVC压差由支架置入前的17.8mmHg降至支架置入后的7.6mmHg（P < 0.001）。临床成功率为100%。在平均6个月（范围10天-13个月）的随访期内，25例患者接受了后续抗癌治疗。6例患者（12.8%）在支架插入后1 - 189天（中位数76天）发生支架再梗阻。所有患者均在随访期间死亡。中位支架通畅时间和生存期分别为339天和167天。累积3个月、6个月和12个月支架通畅率分别为93.4%、87.4%和81.2%。累积3、6和12个月生存率分别为83、38.3和2.1%。肿瘤分期较低（P = 0.018）和支架置入术后的抗癌治疗（P = 0.009）是支架置入术后生存时间延长的独立预测因素。结论支架置入术是治疗恶性SVC综合征简单、安全、有效的方法。支架植入后的后续抗癌治疗可能会增加生存率。
Purpose To determine the clinical effectiveness and long-term outcome of stent insertion for malignant superior vena cava (SVC) syndrome.Materials and methods From June 2010 to April 2016, 47 patients with malignant SVC syndrome were treated with stent insertion in our center. Data regarding the technical success, clinical success, and long-term outcome were collected and analyzed retrospectively.Results SVC stent insertion was successfully performed in all patients. A total of 65 stents were used. No procedure-related complication occurred in these patients. The mean SVC pressure gradient decreased from 17.8 mmHg before stent insertion to 7.6 mmHg after stent insertion (P < 0.001). Clinical success was 100%. During a mean follow-up period of 6 months (range 10 days-13 months), 25 patients underwent subsequent anti-cancer treatment. Six patients (12.8%) experienced re-obstruction of stent 1 to 189 days (median 76 days) after stent insertion. All patients died during the follow-up. The median stent patency time and survival were 339 and 167 days, respectively. The cumulative 3-, 6-, and 12-month stent patency rates were 93.4, 87.4, and 81.2%, respectively. The cumulative 3-, 6-, and 12-month survival rates were 83, 38.3, and 2.1%, respectively. The independent predictors of prolonging survival after stent insertion were lower tumor stage (P = 0.018) and subsequent anti-cancer treatment after stent insertion (P = 0.009).Conclusion Stent insertion is a simple, safe, and effective method for patients with malignant SVC syndrome. Subsequent anti-cancer treatment after stent insertion may increase the survival.