Universität zu Köln

Paul, Gregor, Echterdiek, Fabian ORCID: 0000-0001-7239-4959, Bohle, Wolfram and Zoller, Wolfram (2020). Vocal Fold Paralysis is a Common Complication in Esophageal Cancer Patients with Esophagorespiratory Fistula. J. Gastrointest. Liver Dis., 29 (1). S. 11 - 18. CLUJ-NAPOCA: MEDICAL UNIV PRESS. ISSN 1842-1121

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Abstract

Background & Aims: The development of an esophagorespiratory fistula (ERF) in patients with esophageal cancer (EC) is associated with poor prognosis. We observed a high rate of vocal fold paralysis (VFP) in patients with ERF. Data on prevalence and complications of VFP in ERF are lacking. The present study investigated the incidence of VFP in patients with malignant ERF and examined possible risk factors and the impact on survival. Methods: We performed a retrospective case-control study of 46 institutional cases of EC patients with ERF in a time period of eleven years. Patients were matched to 92 randomly selected controls (EC patients without ERF) in a 1:2 fashion for tumor localization and histology. Demographics, clinical characteristics, recurrence, treatment modalities as well as survival were analyzed. Results: Esophageal cancer patients with ERF developed more often VFP than EC patients without ERF (59% vs. 21%; p=0.02; odds ratio (OR) 4.9). Esophageal cancer patients with ERF had a more pronounced weight loss (7.1 vs. 11.5 kg; P = 0.008), as well as higher rates of esophageal (p=<0.001; OR 22.9) and tracheal stenting (p=<0.001; OR 76.8). Proximal tumor growth (p=0.004; OR 7.9), fistula formation to the trachea (p=<0.001; OR 17.2) and recurrent disease (p=0.04, OR 4.7) was associated with VFP development in EC patients with ERF. Vocal fold paralysis in ERF did not adversely affect five-year survival. Conclusions: Vocal fold paralysis is a common complication in more than half of the patients with ERF in EC. It is associated with proximal tumor growth, fistula formation to the trachea and disease recurrence, but does not influence survival.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Paul, Gregor UNSPECIFIED UNSPECIFIED UNSPECIFIED Echterdiek, Fabian UNSPECIFIED orcid.org/0000-0001-7239-4959 UNSPECIFIED Bohle, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoller, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-341959
DOI:	10.15403/jgld-580
Journal or Publication Title:	J. Gastrointest. Liver Dis.
Volume:	29
Number:	1
Page Range:	S. 11 - 18
Date:	2020
Publisher:	MEDICAL UNIV PRESS
Place of Publication:	CLUJ-NAPOCA
ISSN:	1842-1121
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXPANDABLE METAL STENT; CORD PARALYSIS; IMMOBILITY; PREDICTORS; MANAGEMENT; CARCINOMA Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34195