GIANTURCO STENT PLACEMENT IN MALIGNANT CAVAL OBSTRUCTION - ANALYSIS OF FACTORS FOR PREDICTING THE OUTCOME

PURPOSE: To determine the factors that may be used to predict outcome of stent placement in patients with malignancies obstructing the super ior or inferior vena cava. MATERIALS AND METHODS: Gianturco stents wer e placed in 39 patients with malignant obstruction of the superior (n = 16) or inferior (n = 23) vena cava. Thirteen patients with obstructi on of the superior vena cava received radiation therapy and/or chemoth erapy at some time in their course of treatment. Computed tomographic (CT) scans were obtained in all patients. The authors analyzed treatme nt outcome with the location, length, and CT appearance of obstruction . RESULTS: Venous congestive symptoms disappeared after stent placemen t in 35 patients and remained in four. Symptoms did not recur during 1 -13-month follow-up in 32 of the 35 patients in whom the symptoms disa ppeared. Nonfatal complications were observed in nine patients. Result s of multivariate analysis showed that the outcome of stent placement is best predicted by the appearance of obstructions on CT scans irresp ective of the location and length of the lesions. CONCLUSION: Good res ults can be expected from placement of Gianturco stents except when CT shows the obstruction to be totally enveloped by tumor.