Management of Malignant Stenoses of the Airways. A Prospective Study on130 Patients with Long-term Follow up

Overview

Background.
The malignant stenoses complicate the course of the disease in about 50% of patients with lung tumors.Management of them can influence the quality of life of the afflicted. There is no general agreement about optimalmethods of their therapy, of selection of the best methods and also there is only few data about survival of thesepatients.Methods and Results. 130 patientswith tumors stenoses of the airways were prospectively followed in the 1998-2003period, 93 of themsuffered from lung cancer. Besides other treatment of the tumor they underwent also interventionalbronchoscopy (Nd YAG laser, electrocautery i.e.). The airways were opened completely in 62% of the set of patients.The interventional bronchoscopy was complicated in 9% of patients, 32 patients lived at the 31st December of 2003,98 of them had died. One year survival was 23,1%, median survival of the whole set of patients was 7 months. Thepatients with lung cancer had significantly worse survival than patients with other types of lung tumors, 6 monthsversus 10 months. There were no significant survival differences of the whole set according to the achieved gradeof recanalisation, or according the inclusion of the brachytherapy to the set of interventional methods. The patientswith inserted stent had significantly worse prognosis than the those without stenting. To homogenize the study group,the subset of patients with epidermoid lung cancer in the stage IIIB were selected (n = 51). Significantly longersurvival of patients with complete recanalisation, insignificant longer survival in patients who underwent alsobrachytherapy and significantly shorter survival in patients with stenting were proved in this subgroup of patients.Conclusions. The interventional bronchoscopy has a low rate of complications and in most cases it has a palliativeeffect. The survival of patients is more influenced by the extension and the type of the tumor, their general status,polymorbidity, age etc. than by effect or selection of interventional bronchoscopical methods.

Key words:
interventional bronchoscopy, malignant stenosis of the airways, lung cancer, survival.