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Prognostic factors after therapeutic bronchoscopy for tracheo- or bronchoesophageal fistulas: Results from the EpiGETIF registry

2024; European Respiratory Society; Linguagem: Inglês

10.1183/23120541.00435-2024

2312-0541

Juliette Edme, C. Fournier, Benoît Lepage, Claudia Zea Obando Ep Chateau, L. Cellerin, F. Wallyn, Gavin Plat, Valentin Héluain, Samy Lachkar, T. Egenod, Christophe Gut Gobert, L. Perrot, Christine Lorut, A. Lefebvre, J.M. Vergnon, Valérian Bourinet, Pascalin Roy, Julien Legodec, Hervé Dutau, Nicolas Guibert,

Lung Cancer Diagnosis and Treatment

Introduction Treatment of malignant tracheo- or bronchoesophageal fistulas (TEF) using therapeutic bronchoscopy (TB) is not standardized and its outcomes are poorly described. This study aimed to analyze the characteristics of patients treated with TB for a TEF and to identify prognostic factors. Methods We analyzed data from 96 patients undergoing TB for TEF entered in the EpiGETIF registry between January 2019 and December 2022. Results The mean age was 61.4 years. Median survival after TB was 2.40 months (95% CI 1.81–3.32). Histology was mainly represented by esophageal (72%) and lung (23%) cancers and did not influence prognosis (p=0.15), whereas smoking did (2.17 versus 3.32 months for non-smokers, p=0.04). Patients with poor performance status (Eastern Cooperative Oncology Group >2) had shorter survival (1.99 versus 3.02 months, p=0.04). Sixty nine percent of patients had already received oncologic treatment, with no difference in survival (3.02 versus 2.21 months for treatment-naive patients, p=0.14). Neither the localization (trachea 61.5%, left main bronchus 34.4%, other 4.1%) nor the size of the fistulas (23% <5 mm, 20% 5–10 mm, 54% >10 mm) impacted survival (p=0.91 and p=0.83, respectively). An airway stent (AS) was placed in 92.7% of patients, mainly self-expanding metallic stents (45%). Patients treated with both an esophageal and AS had a better prognosis than patients treated with an AS alone (2.88 versus 1.77 months, respectively, p=0.02). Conclusion Survival of patients treated with TB for a TEF is very poor, and is impacted by smoking, performance status, and the presence of an esophageal stent.