ERJ open research · 2025
Prognostic factors after therapeutic bronchoscopy for tracheo- or broncho-oesophageal fistulas: results from the EpiGETIF registry.
СтатьяНазвание и аннотация: Перевод в очереди
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Edme Juliette, Fournier Clément, Lepage Benoit, Zea Obando Ep Chateau Claudia, Cellerin Laurent, Wallyn Frederic, Plat Gavin, Héluain Valentin, Lachkar Samy, Egenod Thomas, Gut Gobert Christophe, Perrot Loic, Lorut Christine, Lefebvre Aurélie, Vergnon Jean Michel, Bourinet Valerian, Roy Pascalin, Legodec Julien, Dutau Hervé, Guibert Nicolas
Аннотация
INTRODUCTION: Treatment of malignant tracheo- or broncho-oesophageal fistulas (TOF) using therapeutic bronchoscopy (TB) is not standardised and its outcomes are poorly described. This study aimed to analyse the characteristics of patients treated with TB for a TOF and to identify prognostic factors.
METHODS: We analysed data from 96 patients undergoing TB for TOF entered in the EpiGETIF registry between January 2019 and December 2022.
RESULTS: The mean age was 61.4 years. Median survival after TB was 2.40 months (95% CI 1.81-3.32). Histology was mainly represented by oesophageal (72%) and lung (23%) cancers and did not influence prognosis (p=0.15), whereas smoking did (2.17 versus 3.32 months for nonsmokers, p=0.04). Patients with poor performance status (Eastern Cooperative Oncology Group >2) had shorter survival (1.99 versus 3.02 months, p=0.04). 69% of patients had already received oncologic treatment, with no difference in survival (3.02 versus 2.21 months for treatment-naive patients, p=0.14). Neither the localisation (trachea 61.5%, left main bronchus 34.4%, other 4.1%) nor the size of the fistulas (23% <5 mm, 20% 5-10 mm, 54% >10 mm) impacted survival (p=0.91 and p=0.83, respectively). An airway stent (AS) was placed in 92.7% of patients, mainly self-expanding metallic stents (45%). Patients treated with both an oesophageal stent and AS had a better prognosis than patients treated with an AS alone (2.88 versus 1.77 months, respectively, p=0.02).
CONCLUSION: Survival of patients treated with TB for a TOF is very poor, and is impacted by smoking, performance status and the presence of an oesophageal stent.
METHODS: We analysed data from 96 patients undergoing TB for TOF entered in the EpiGETIF registry between January 2019 and December 2022.
RESULTS: The mean age was 61.4 years. Median survival after TB was 2.40 months (95% CI 1.81-3.32). Histology was mainly represented by oesophageal (72%) and lung (23%) cancers and did not influence prognosis (p=0.15), whereas smoking did (2.17 versus 3.32 months for nonsmokers, p=0.04). Patients with poor performance status (Eastern Cooperative Oncology Group >2) had shorter survival (1.99 versus 3.02 months, p=0.04). 69% of patients had already received oncologic treatment, with no difference in survival (3.02 versus 2.21 months for treatment-naive patients, p=0.14). Neither the localisation (trachea 61.5%, left main bronchus 34.4%, other 4.1%) nor the size of the fistulas (23% <5 mm, 20% 5-10 mm, 54% >10 mm) impacted survival (p=0.91 and p=0.83, respectively). An airway stent (AS) was placed in 92.7% of patients, mainly self-expanding metallic stents (45%). Patients treated with both an oesophageal stent and AS had a better prognosis than patients treated with an AS alone (2.88 versus 1.77 months, respectively, p=0.02).
CONCLUSION: Survival of patients treated with TB for a TOF is very poor, and is impacted by smoking, performance status and the presence of an oesophageal stent.