Percutaneous gastrostomy compared with esophageal stenting for the treatment of esophageal cancer with dysphagia.

PURPOSE To compare the outcomes of self-expandable metal stent and percutaneous gastrostomy (PG) for treatment of patients with esophageal cancer (EC) and dysphagia. MATERIALS AND METHODS This retrospective observational study consisted of 113 patients with EC and dysphagia who underwent either stent insertion (n = 47) or PG (n = 66) at a single center between June 2014 and June 2018. RESULTS There were 63 men and 50 women with the mean age of 76.5 ± 4.9 years. The two groups had similar baseline characteristics, except that the PG group had a higher percentage of patients with cervical EC (22.7%. vs 2.1%, P < 0.001). The PG group had better maintenance of nutritional status in terms of reduction of serum albumin level (P = 0.039) and weight loss (P = 0.041). Compared with the stent group, the PG group demonstrated a lower incidence of local severe pain (0% vs 21.3%, P < 0.001), and lower incidence of dislodgment of device (1.5% vs 19.1%, P = 0.002). The PG group demonstrated longer overall survival than the stent group, for stages II and III (201 vs 185 days, P = 0.034) and stage IV (122 vs 86 days, P = 0.001). CONCLUSION Compared with stent insertion, PG is associated with better maintenance of nutritional status, fewer complications, and better survival. Thus, PG may be the preferred choice for treating malnutrition in patients with EC and dysphagia.