Inoperable Esophageal Cancer and Outcome of Palliative Care in Golestan

Background and Objective: Dysphagia is the most distressing problem in patients with advanced inoperable esophageal cancer. Palliative interventions like balloon dilation and stenting are used to improve quality of life and make patients enable to eat more comfortably. This study was designed to determine the outcome of palliative care in esophageal cancer patients referred to Gorgan and Gonbad gastrointestinal clinics, northeast Iran. Materials and Methods: This cross-sectional study was performed on inoperable esophageal cancer cases during ۲۰۰۵-۲۰۰۶. Demographic data were collected during the procedure and cases were followed every month for six months. Improvement proportion was calculated with ۹۵% confidence interval, to determine the rate of improvement. Survival analysis and Kaplan-Meier methods were used to estimate the duration of palliative care effectiveness. Results: We recruited ۳۹ cases into the study. Male to female ratio was ۱.۶ to ۱ and mean age was ۶۷.۵± ۱۳.۷ years. Twenty two patients had grade ۳ dysphagia and other ۱۷ had grade ۴ at the begining of the study. Dilation was the most preferred method (۸۹.۷%) and stenting was performed in ۴ (۱۰/۳%) cases. Decreasing dysphagia score was not related to palliation method used or pathologic type of carcinoma but it was showed to be related to the age of the patients significantly. Mean survival was significantly different between ۲ groups (with and without dysphagia improvement in first month of follow-up). Conclusions: Results of this study showed a lower survival rate after palliative care in advanced esophageal cancer cases, although dysphagia scores showed some improvement.

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Key words: Esophageal cancer , Palliative care , Grading of dysphagia , Iran