Indications of airway stenting for severe central airway obstruction due to advanced cancer

• Published in: PloS one Vol. 12; no. 6; p. e0179795
• Main Authors: Nagano, Hiroaki, Kishaba, Tomoo, Nei, Yuichirou, Yamashiro, Shin, Takara, Hiroaki
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.06.2017; Public Library of Science (PLoS)
• Subjects: Activities of daily living; Aged; Airway Extubation; Airway management; Airway obstruction; Airway Obstruction - etiology; Airway Obstruction - mortality; Airway Obstruction - therapy; Albumin; Anesthesia; Cancer; Chemotherapy; Comparative analysis; Dyspnea; Esophageal cancer; Failure analysis; Female; Health aspects; Hospitals; Humans; Lung cancer; Male; Medical prognosis; Medical records; Medical research; Medicine; Middle Aged; Mortality; Multivariate analysis; Neoplasms - complications; Oncology; Opioids; Palliative Care; Patients; Prognosis; Proportional Hazards Models; Quality; Quality of life; Radiation therapy; Respiratory failure; Respiratory tract; Retrospective Studies; Serum albumin; Smoking; Stents; Studies; Survival; Trachea; Tracheal Stenosis - etiology; Tracheal Stenosis - mortality; Tracheal Stenosis - therapy; United States; United States; Japan; Okinawa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0179795

Management of severe central airway obstruction due to advanced cancer is a medical and technical challenge. The impact of airway stenting on the clinical outcome of such patients is unclear. This single-center, retrospective study evaluated 21 patients who underwent airway stenting for advanced cancer. We examined predictors of the post-stenting mortality, including age, serum albumin, tracheal diameter, smoking, opioid use, respiratory failure, and performance status (PS). We also compared survival according to the PS. The mean survival period after stenting was 85.2 days. On univariate analysis, age, albumin, PS before airway stenting, respiratory failure, admission route, and PS grade were the candidates as possible predictors of prognosis after the procedure. On multivariate analysis, PS before airway stenting was identified as possible predictor of prognosis after stenting (HR 1.6180, 95% CI 0.969 to 2.7015, p = 0.066). The mean survival period after stenting was significantly longer in the good PS group, compared to the poor PS group (147.8 days vs. 38.2 days,p = 0.0346). Airway stenting for advanced cancer may be more effective for patients in good general condition than in those with poor performance status.