Dual stenting in malignant tracheoesophageal fistula: survival and quality of life in long-term follow-up

OBJECTIVE: To evaluate the impact of dual tracheal and oesophageal stenting on quality of life (QoL) in Indian patients with malignant tracheoesophageal fistula (TEF) in patients of oesophageal cancer and to describe associated clinical outcomes following this palliative intervention. METHODS: This prospective observational study included 12 patients with malignant TEF who underwent dual tracheal and oesophageal stenting at a tertiary oncology centre in India between 2022 and 2024. QoL was assessed preprocedure and 6-8 weeks poststenting using the Functional Assessment of Cancer Therapy-Oesophageal questionnaire in Hindi and English. Clinical outcomes, dysphagia grades and survival were also recorded. RESULTS: Median age was 53 years, with 58% female patients. Dual stenting provided rapid relief of dysphagia and respiratory symptoms. Most patients rated overall health and QoL between 4 and 5 on a 7-point scale poststenting. A strong correlation was observed between symptom relief and QoL (r=0.88), with physical, functional and social well-being domains showing the highest improvement. Overall survival was 5.7 months (range: 3-21 months). Patients achieving greater dysphagia relief reported higher QoL and health scores. CONCLUSIONS: Dual tracheal and oesophageal stenting significantly improves symptomatic control and QoL in patients with malignant TEF, particularly in physical, functional and social domains.