Prognostic factors for bronchoscopic intervention in advanced lung or esophageal cancer patients with malignant airway obstruction

• Main Authors: Jae-Uk Song, Hye Yun Park, Hojoong Kim, Kyeongman Jeon, Sang-Won Um, Won-Jung Koh, Gee Young Suh, Man Pyo Chung, O Jung Kwon
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Annals of Thoracic Medicine
• Subjects: Airway obstruction; bronchoscopy; esophageal cancer; lung cancer; survival
• Online Access: http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2013;volume=8;issue=2;spage=86;epage=92;aulast=Song

Context: Bronchoscopic intervention can provide immediate relief from suffocation and an opportunity for additional treatment in patients with malignant airway obstruction. However, few studies have specifically identified prognostic factors affecting the survival of advanced lung or esophageal cancer patients receiving bronchoscopic intervention. Aims: We aimed to investigate prognostic factors influencing survival in these patients. Study Design: We conducted retrospective study. Methods: The clinical parameters were retrospectively reviewed in 51 patients (lung cancer: n = 35; esophageal cancer: n = 16) who underwent palliative bronchoscopic interventions due to malignant airway. Results: Bronchoscopic interventions, such as mechanical removal ( n = 26), stenting ( n = 31), laser cauterization ( n = 19), and ballooning ( n = 16), were performed on intraluminal ( n = 21, 41%), extrinsic ( n = 8, 16%), and combined lesions ( n = 22, 43%). Tracheal invasion was found in 24 patients (47%). Successful palliation was achieved in 49 patients (96%). After the intervention, additional anti-cancer treatment was followed in 24 patients (47%). The median survival time and overall survival rate were 3.4 months and 4%. Survival was increased with selected conditions, including a treatment-naοve status (hazard ratio [HR], 0.359; confidence interval [CI], 0.158-0.815; P = 0.01), an intact proximal airway (HR, 0.265; CI, 0.095-0.738; P = 0.01), and post-procedural additional treatment (HR, 0.330; CI, 0.166-0.657; P < 0.01). Conclusions: Brochoscopic intervention could provide immediate relief and survival improvement in advanced lung or esophageal cancer patients with selected conditions such as a treatment-naοve status, an intact proximal airway, and available post-procedural additional treatment.