Stent insertion for malignant superior vena cava syndrome: effectiveness and long-term outcome.

PURPOSE: To determine the clinical effectiveness and long-term outcome of stent insertion for malignant superior vena cava (SVC) syndrome.

MATERIALS AND METHODS: From June 2010 to April 2016, 47 patients with malignant SVC syndrome were treated with stent insertion in our center. Data regarding the technical success, clinical success, and long-term outcome were collected and analyzed retrospectively.

RESULTS: SVC stent insertion was successfully performed in all patients. A total of 65 stents were used. No procedure-related complication occurred in these patients. The mean SVC pressure gradient decreased from 17.8 mmHg before stent insertion to 7.6 mmHg after stent insertion (P < 0.001). Clinical success was 100%. During a mean follow-up period of 6 months (range 10 days-13 months), 25 patients underwent subsequent anti-cancer treatment. Six patients (12.8%) experienced re-obstruction of stent 1 to 189 days (median 76 days) after stent insertion. All patients died during the follow-up. The median stent patency time and survival were 339 and 167 days, respectively. The cumulative 3-, 6-, and 12-month stent patency rates were 93.4, 87.4, and 81.2%, respectively. The cumulative 3-, 6-, and 12-month survival rates were 83, 38.3, and 2.1%, respectively. The independent predictors of prolonging survival after stent insertion were lower tumor stage (P = 0.018) and subsequent anti-cancer treatment after stent insertion (P = 0.009).

CONCLUSION: Stent insertion is a simple, safe, and effective method for patients with malignant SVC syndrome. Subsequent anti-cancer treatment after stent insertion may increase the survival.