Treatment of malignant superior vena cava syndrome by endovascular stent insertion. Experience on 52 patients with lung cancer

Lung Cancer. 2004 Feb;43(2):209-14. doi: 10.1016/s0169-5002(03)00361-1.

Abstract

Background: Superior vena cava syndrome (SVCS) is a frequent presentation of malignancies involving the mediastinum and can seriously compromise treatment options and prognosis. Stenting of superior vena cava is a well-known but not so commonly used technique to alleviate this syndrome.

Patients and methods: Between August 1993 and December 2000 we performed 52 stenting procedures in patients affected by non-small cell lung cancer (NSCLC).

Results: Phlebographic resolution of the obstruction was achieved in 100% of cases with symptomatic and subjective improvement in more than 80%. One major complication was observed due to bleeding during anticoagulation. Re-obstruction of the stent occurred in only 17% of the cases, the majority due to disease progression. Improvement of the syndrome allowed hydration necessary for full dose platinum treatment when indicated in patients affected by lung cancer.

Conclusions: Stenting of the superior vena cava syndrome is a safe and effective procedure achieving a rapid alleviation of symptoms in almost all patients, and allowing for full dose treatment in lung cancer patients. This procedure could change the traditional poorer prognosis attributed to non-small cell lung cancer patients presenting with this syndrome.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use
  • Disease Progression
  • Female
  • Hemorrhage / etiology
  • Humans
  • Lung Neoplasms / complications*
  • Male
  • Middle Aged
  • Prognosis
  • Stents*
  • Superior Vena Cava Syndrome / etiology*
  • Superior Vena Cava Syndrome / pathology
  • Superior Vena Cava Syndrome / surgery*
  • Treatment Outcome
  • Vascular Surgical Procedures / instrumentation
  • Vascular Surgical Procedures / methods*

Substances

  • Anticoagulants