Järvinen T, et al. – Authors here determined the effect of preoperative self–expanding covered metallic stent (SEMS) on survival, progression–free survival (PFS), operative time and complication rates in oesophageal cancer (EC). SEMS application seemed to have no relevant effect on survival, PFS or complications. The SEMS insertion group had significantly higher mean operative time. Thereby suggesting that preoperative SEMS insertion made the operation more challenging by increasing operative time, but was otherwise a feasible and safe strategy in experienced centres as a bridge to surgery.

Methods

• From January 2006 to January 2014, authors included EC patients undergoing surgery with a cT2 tumour or higher (n = 174; 135 adenocarcinomas and 39 squamous cell carcinomas).
• They propensity matched 1:1 a preoperative SEMS group (n = 30) to a control group.
• Despite the propensity matching, persistence of statistically non-significant residual covariate imbalances was observed.
• Patients were followed up for a median period of 33 months (range: 0–118 months).
• Kaplan–Meier survival analysis was performed for OS and PFS, the Student's t-test for operative time and the chi-squared test for complication rates.

Results

• In this study, median survival in the SEMS group was 28.5 months (range: 0–116 months) vs 34 months (4–118 months) in the control group and median PFS was 22 months (0–111 months) vs 27 (4–113 months) (P = 0.748 and P = 0.764, respectively).
• The groups indicated mean operative times of 436 min vs 375 min (P = 0.017).
• Findings revealed no differences regarding intraoperative (23.3% vs 10%, P = 0.299), early (50.0% vs 46.7%, P = 1) or late complication rates (53.3% vs 43.3%, P = 0.606).