Monday, June 12, 2006
Stenting and lung cancer
Just curious what you all think of the role of stenting in advanced lung cancer. This obviously would not effect such hard endpoins as survival, but it seems to alleviate dyspnea and might mpact on quality of life. Unfortunately I do not think there is much data out there to support this, but this does not necessarily mean that these endpoints are not impacted. Until there is data, what are you all doing with advanced lung ca with regards to interventional bronchoscopy?
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I have looked that up before as well. There is actually good data on improved performance status and quality of life. For nice pictures and good physiologic data check out Miyazawa et al. AJRCCM 2004; 169. pp. 1096-1102.
You are right there does seem to be a bit of data out there supporting the notion that qual of life is improved with stenting. Sometimes it's hard to escape the bias that if it wasn't done at our place of training (U of M) it must not have a role. Obviously this is not true. But it is somewhat suprising that interventional bronch is not done there....
I agree. We also use APC (argon plasma photocoagulation) here with very good palliative success.
No dig meant. The original intent of the post was to look into the discrepancy between 2 institutions' use of stenting because I want to know what role stents play in lung cancer palliation. I hope I am allowed to say (without interpretation that statemtn is a "dig" that I find it suprising that a major center doesn't do stenting. My initial impression was that *because* of this, perhaps the role of stenting is not particularly strong. We seem to do a *lot* of stenting here for nonoperable lung cancer which is in stark contrast to UM. The conclusion from that is either a) we do too many here and there's no data to support it or b)there is a definiate role and thus it would be suprising that UM doesn't do it (since there is a lot of inoperable lung Ca there as well.
I hope I am can be suprised by that without giving off the impression that I am criticizing (because I wasn't).
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