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Efficiency of endovascular stenting in the treatment of malignancy related vena cava superior syndrome: single center experience

Year 2018, Volume: 10 Issue: 4, 449 - 453, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.457666

Abstract

Aim: To
evaluate efficacy of the endovascular stenting for symptomatic treatment of
malignancy-related vena cava superior (VCS) syndrome.

Material and Method: Thirty-five
patients who underwent endovascular stenting at Baskent University between
December 2005 and October 2016 due to malign VCS were evaluated retrospectively.

Results: A
total of 54 stenting procedures were performed in 35 patients. 48% of the
patients had a single stent and 43% had two stents. Of the patients on
stenting, 6 were women and 29 were men. 68% of all patients were stage 4, and
77% were patients with lung cancer. Symptomatic relief was observed in 31 (89%)
patients after the procedure. Re-stenting was performed in four patients for
stent thrombosis and in two patients for tumor ingrowth. After stenting, 23 patients
were given anti-coagulant treatment. Median overall survival (OS) was 20 weeks
(range, 6.5-33.4) in the whole group. In patients with lung cancer, OS after
stenting was found to be numerically shorter than other groups, but it did not
reach statistical significance.







Conclusion: Endovascular stenting in the palliative treatment of
malignancy-related SVC syndrome is an effective treatment method with high
clinical success and low morbidity both in newly diagnosed patients and in
patients on progression.

References

  • 1. Cheng S. Superior vena cava syndrome: a contemporary review of a historic disease. Cardiol Rev, 2009; 17(1): p. 16-23.
  • 2. Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore) 2006; 85:37.
  • 3. Armstrong BA, Perez CA, Simpson JR, Hederman MA. Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 1987; 13:531.
  • 4. Wilson, L.D., F.C. Detterbeck, and J. Yahalom. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med, 2007; 356(18): p. 1862-9.
  • 5. Dombernowsky P, Hansen HH. Combination chemotherapy in the management of superior vena caval obstruction in small-cell anaplastic carcinoma of the lung. Acta Med Scand 1978; 204:513.
  • 6. Kvale PA, Selecky PA, Prakash UB. American College of Chest Physicians. Palliative care in lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132:368S.
  • 7. Dondelinger RF, Goffette P, Kurdziel JC, Roche A. Expandable metal stents for stenoses of the ve- nae cavae and large veins. Semin Intervent Radiol 1991; 8:252–263.
  • 8. Wurschmidt F, Bunemann H, Heilmann HP. Small cell lung cancer with and without superior vena cava syndrome: a multivariate analysis of prognostic factors in 408 cases. Int J Radiat Oncol Biol Phys 1995; 33:77–82.
  • 9. Urban T, Lebeau B, Chastang C, et al. Superior vena cava syndrome in small cell lung cancer. Arch Intern Med 1993; 153:384–387
  • 10. Charnsangavej C, Carrasco CH, Wallace S, et al. Stenosis of the vena cava: preliminary assessment of treatment with expandable metallic stents. Radiology, 1986; 161(2): p. 295-8.
  • 11. Gauden, S.J., Superior vena cava syndrome induced by bronchogenic carcinoma: is this an oncological emergency? Australas Radiol, 1993; 37(4): p. 363-6.
  • 12. Schraufnagel DE, Hill R, Leech JA, Pare JA. Superior vena caval obstruction. Is it a medical emergency? Am J Med, 1981; 70(6): p. 1169-74.
  • 13. Uberoi R. Quality assurance guidelines for superior vena cava stenting in malignant disease. Cardiovasc Intervent Radiol 2006; 29:319.
  • 14. Oudkerk M, Kuijpers TJ, Schmitz PI, et al. Self-expanding metal stents for palliative treatment of superior vena caval syndrome. Cardiovasc Intervent Radiol 1996; 19:146.
  • 15. Nagata T, Makutani S, Uchida H, et al. Follow-up results of 71 patients undergoing metallic stent placement for the treatment of a malignant obstruction of the superior vena cava. Cardiovasc Intervent Radiol 2007; 30:959.
  • 16. Lanciego C, Chacón JL, Julián A, et al. Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. AJR Am J Roentgenol 2001; 177:585.
  • 17. Martins SJ, Pereira JR. Clinical factors and prognosis in non-small cell lung cancer. Am J Clin Oncol 1999; 22:453.

Malignite ilişkili vena kava superior sendromunun tedavisinde stent uygulanmasının etkinliği: tek merkez deneyimi

Year 2018, Volume: 10 Issue: 4, 449 - 453, 01.12.2018
https://doi.org/10.21601/ortadogutipdergisi.457666

Abstract

Amaç: Malignite ilişkili
vena kava superior (VKS) sendromunun semptomatik tedavisinde endovasküler stent
uygulanan hastalarda bu yaklaşımın etkinliğini değerlendirmeyi amaçladık.

Gereç ve Yöntem: Malign VKS sendromu
nedeniyle Başkent Üniversitesinde Aralık 2005- Ekim 2016 tarihleri arasında
endovasküler stent uygulanan 35 hasta retrospektif olarak incelenmiştir.

Bulgular: 35 hastaya toplam 54
stent işlemi gerçekleştirilmiştir
.
Hastaların %48’ine tek stent %43’üne ise iki stent konulmuştur. Stent uygulanan
hastaların 6’sı kadın 29’u ise erkekti. Tüm
hastaların %68’ini evre 4, %77’sini akciğer
kanserli hastalar oluşturmuştur. İşlem sonrası 31 (%89) hastada semptomatik
rahatlama gözlenmiştir. Hastaların takibinde 4 hastada stent trombozu 2 hastada
ise tümör basısı nedeni ile re-stent ihtiyacı olmuştur. Stent sonrası 23
hastaya anti-koagülan tedavi verilmiştir. Tüm grupta ortanca genel sağkalım
(GSK) 20 hafta (aralık 6,5-33,4 ) olarak bulunmuştur. Stent sonrası akciğer
kanserli hastalarda GSK diğer gruplara göre sayısal olarak daha kısa olarak
bulunmuş ancak istatistiksel anlamlılığa ulaşmamıştır.







Sonuç: Malignite ilişkili SVK
sendromunun palyatif tedavisinde endovasküler stent uygulanması tanı anında ya
da progresif hastalık durumunda yüksek klinik başarı ve düşük morbidite ile
etkin bir tedavi yöntemidir. 

References

  • 1. Cheng S. Superior vena cava syndrome: a contemporary review of a historic disease. Cardiol Rev, 2009; 17(1): p. 16-23.
  • 2. Rice TW, Rodriguez RM, Light RW. The superior vena cava syndrome: clinical characteristics and evolving etiology. Medicine (Baltimore) 2006; 85:37.
  • 3. Armstrong BA, Perez CA, Simpson JR, Hederman MA. Role of irradiation in the management of superior vena cava syndrome. Int J Radiat Oncol Biol Phys 1987; 13:531.
  • 4. Wilson, L.D., F.C. Detterbeck, and J. Yahalom. Clinical practice. Superior vena cava syndrome with malignant causes. N Engl J Med, 2007; 356(18): p. 1862-9.
  • 5. Dombernowsky P, Hansen HH. Combination chemotherapy in the management of superior vena caval obstruction in small-cell anaplastic carcinoma of the lung. Acta Med Scand 1978; 204:513.
  • 6. Kvale PA, Selecky PA, Prakash UB. American College of Chest Physicians. Palliative care in lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 2007; 132:368S.
  • 7. Dondelinger RF, Goffette P, Kurdziel JC, Roche A. Expandable metal stents for stenoses of the ve- nae cavae and large veins. Semin Intervent Radiol 1991; 8:252–263.
  • 8. Wurschmidt F, Bunemann H, Heilmann HP. Small cell lung cancer with and without superior vena cava syndrome: a multivariate analysis of prognostic factors in 408 cases. Int J Radiat Oncol Biol Phys 1995; 33:77–82.
  • 9. Urban T, Lebeau B, Chastang C, et al. Superior vena cava syndrome in small cell lung cancer. Arch Intern Med 1993; 153:384–387
  • 10. Charnsangavej C, Carrasco CH, Wallace S, et al. Stenosis of the vena cava: preliminary assessment of treatment with expandable metallic stents. Radiology, 1986; 161(2): p. 295-8.
  • 11. Gauden, S.J., Superior vena cava syndrome induced by bronchogenic carcinoma: is this an oncological emergency? Australas Radiol, 1993; 37(4): p. 363-6.
  • 12. Schraufnagel DE, Hill R, Leech JA, Pare JA. Superior vena caval obstruction. Is it a medical emergency? Am J Med, 1981; 70(6): p. 1169-74.
  • 13. Uberoi R. Quality assurance guidelines for superior vena cava stenting in malignant disease. Cardiovasc Intervent Radiol 2006; 29:319.
  • 14. Oudkerk M, Kuijpers TJ, Schmitz PI, et al. Self-expanding metal stents for palliative treatment of superior vena caval syndrome. Cardiovasc Intervent Radiol 1996; 19:146.
  • 15. Nagata T, Makutani S, Uchida H, et al. Follow-up results of 71 patients undergoing metallic stent placement for the treatment of a malignant obstruction of the superior vena cava. Cardiovasc Intervent Radiol 2007; 30:959.
  • 16. Lanciego C, Chacón JL, Julián A, et al. Stenting as first option for endovascular treatment of malignant superior vena cava syndrome. AJR Am J Roentgenol 2001; 177:585.
  • 17. Martins SJ, Pereira JR. Clinical factors and prognosis in non-small cell lung cancer. Am J Clin Oncol 1999; 22:453.
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original article
Authors

Ali Ayberk Beşen

Publication Date December 1, 2018
Published in Issue Year 2018 Volume: 10 Issue: 4

Cite

Vancouver Beşen AA. Malignite ilişkili vena kava superior sendromunun tedavisinde stent uygulanmasının etkinliği: tek merkez deneyimi. omj. 2018;10(4):449-53.

e-ISSN: 2548-0251

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