Study objectives: To evaluate the palliative benefit of
stent insertion in a group of patients with central airways obstruction
due to terminal cancer.
Design: Retrospective analysis
of the symptomatic score of patients immediately after stent insertion,
and questionnaires completed by the general practitioner (GP) after the
patients died at home.
Setting: Academic hospital,
tertiary referral center for interventional bronchoscopy.
Patients and methods: Fourteen patients with imminent
suffocation due to major obstruction of the central airways, caused by
end-stage esophageal cancer (n = 5) and non-small cell lung cancer
(n = 9), were referred for stent insertion. All prostheses were
placed within 24 h after hospital admittance. Patients were then
asked whether their symptoms had improved. After the patients died, a
questionnaire was sent to each patient’s GP.
All patients expressed immediate benefit after stenting. The average
length of survival after stent insertion was 11 weeks (range, 0.5 to 34
weeks). Two patients died within 1 week in our hospital after stent
placement. In the remaining 12 patients, the GP considered stent
insertion in 7 patients to be worthwhile, no judgment was made in 4
patients, and stent insertion in 1 patient was regarded as futile.
Conclusion: Despite terminal disease and the fact that, in
our country, patients may legally refuse any treatment and formally ask
for euthanasia, the palliative benefit of stent placement should always
be considered. All patients had immediate symptomatic relief
afterwards. Retrospectively, the GPs responsible for terminal care at
home still considered stent insertion worthwhile in 58% (7 of 12
patients) of cases. Stent placement should always be considered as part
of the treatment of terminal cancer patients with imminent