P1057 - Outcomes of Endoscopic Liquid Nitrogen Cryotherapy for Palliation of Esophageal Cancer in Community Practice

Daniel Aintabi, MD, MSc¹, Kais Antonios, MD¹, Ann Saliares, MD², Elliot Berinstein, MD, MSc³, Naresh Gunaratnam, MD^4
1Trinity Health Ann Arbor Hospital, Ann Arbor, MI; ²University of Kentucky, Ann Arbor, MI; ³Michigan Medicine, Ann Arbor, MI; ⁴Huron Gastro, Ann Arbor, MI

Introduction: Endoscopic application of liquid nitrogen cryotherapy causes local tumor cell destruction, offering a minimally invasive therapy for esophageal cancer. While studies at large academic centers have demonstrated improvements in dysphagia and quality of life with palliative cryotherapy in esophageal cancer, outcomes in community practice are lacking. This study aims to report outcomes of cryotherapy for palliation of esophageal cancer in a community hospital setting.

Methods: Trinity Health Ann Arbor database was retrospectively screened for patients with histologic evidence of esophageal cancer that received palliative endoscopic cryotherapy. Patient characteristics including type and stage of cancer, adjuvant therapy, type of intervention, and adverse events related to cryotherapy were noted. Subjective changes in dysphagia and esophageal lumen obstruction were collected.

Results: A total of 26 patients were included. Patient demographics, cryotherapy characteristics, and adverse events were collected. Majority of patients received adjuvant therapy with both chemo and radiation therapy (69.2%). There were no deaths related to cryotherapy. 1 patient had a non-fatal, contained, esophageal microperforation a month after cryotherapy without dilation. 2 patients had esophageal bleeding with dilation, with hemostasis achieved during the same endoscopy. Changes in subjective dysphagia and esophageal lumen obstruction are demonstrated below. Most patients had improved dysphagia (75%) as well as improved lumen obstruction with cryotherapy (88.5%). Cryotherapy with or without balloon dilation was the most commonly used intervention and had the most frequent improvement in subjective dysphagia and lumen obstruction (83.3% and 76.5% respectively).

Discussion: This study demonstrates that cryotherapy is effective and safe for palliation of esophageal cancer in community hospital settings. There were no deaths, two esophageal bleeds, and a nonfatal esophageal microperforation. The majority of patients had improved subjective dysphagia and lumen obstruction with cryotherapy. These findings are similar to a recent study of 55 patients at specialized centers demonstrating improved dysphagia and quality of life with palliative cryotherapy with minimal adverse events. Our study identified that cryotherapy with or without balloon dilation was the most frequently used intervention resulting in improved dysphagia and esophageal lumen obstruction.


Disclosures:


Daniel Aintabi, MD, MSc¹, Kais Antonios, MD¹, Ann Saliares, MD², Elliot Berinstein, MD, MSc³, Naresh Gunaratnam, MD⁴. P1057 - Outcomes of Endoscopic Liquid Nitrogen Cryotherapy for Palliation of Esophageal Cancer in Community Practice, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.