section name header

Evidence summaries

Expandable Metal Stents Vs Plastic Tubes for Inoperable Oesophageal Cancer

Metal stents appear to be more safe than plastic tubes for inoperable oesophageal cancer. Level of evidence: "B"

A systematic review 1 including 6 studies with a total of 277 subjects was abstracted in DARE. One study showed significantly greater improvement in dysphagia with self-expanding metal stents (SEMs) at 1 week (P=0.04), but not at 6 weeks. Life-threatening procedural complications (6 studies): There was a significantly lower risk of perforation or haemorrhage among patients randomised to SEMs than to plastic tubes (RR 0.40, 95% CI: 0.19 to 0.81). Procedure-related mortality (4 studies): There was a significantly lower risk of death among patients randomised to SEMs than to plastic tubes (RR 0.22, 95% CI: 0.07 to 0.75). Device migration (4 studies): There was no significant difference between SEMs and plastic tubes (RR 0.48, 95% CI: 0.22 to 1.05; result in favour of SEMs). Food impaction (6 studies): There was no significant difference between SEMs and plastic tubes (RR 0.64, 95% CI: 0.30 to 1.35; result in favour of SEMs).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

References

  • Gajraj R, Moore D, Jones B, Song F. Expandable metal stents for inoperable oesophageal cancer. Birmingham: University of Birmingham , Department of Public Health and Epidemiology, 2002. [DARE]

Primary/Secondary Keywords