LASER RESECTION AND ENDOBRONCHIAL STENTING IN THE MANAGEMENT OF MALIGNANT CENTRAL AIRWAY OBSTRUCTION: A COMPARATIVE SURVIVAL AND QUALITY OF LIFE ANALYSIS.

BACKGROUND

Malignant central airway obstruction (CAO) is a critical, life-limiting complication in patients with advanced thoracic malignancies. Interventions such as bronchoscopic laser resection and airway stenting can provide rapid palliation and symptom relief, yet comparative data on survival and quality of life (QoL) remain limited.

OBJECTIVE

To assess the impact of bronchoscopic laser resection and stenting on survival and health-related QoL in patients with malignant CAO, compared with conservative palliative care.

METHODS

A comparative cohort study was conducted at a national pulmonary referral center. Thirteen patients underwent bronchoscopic laser resection and/or endobronchial stenting, while twelve control patients received conservative palliative care. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate mortality. Health-related QoL was measured using the EQ-5D-5L questionnaire at baseline and one-month post-intervention.

RESULTS

Median survival in the intervention group was 9.7 weeks compared to 0.6 weeks in the control group (p<0.0001). At 25 weeks, the hazard ratio for death was 0.019 (95% CI: 0.004-0.091). The mean EQ-5D-5L score improved from 29.2±14.4 to 43.5±9.2 (p=0.0062), with the most pronounced improvements in the pain/discomfort and anxiety/depression domains.

CONCLUSION

Bronchoscopic laser resection and airway stenting significantly improve short-term survival and quality of life in patients with malignant CAO. These minimally invasive interventions should be considered integral components of palliative care for patients with inoperable airway obstruction.