Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction

Jae Jun Park, Kwangwon Rhee, Jin Young Yoon, Soo Jung Park, Joo Hee Kim, Jie-Hyun Kim, Young Hoon Youn, Tae Il Kim, HyoJin Park, Won Ho Kim, JaeHee Cheon

Research output: Contribution to journalArticle

Abstract

Background Peritoneal carcinomatosis can influence clinical outcomes of patients receiving self-expandable metal stents (SEMS) for malignant colorectal obstruction, but data regarding this issue are sparse. We analyzed the clinical outcomes of post-SEMS insertion for malignant colorectal obstruction based on carcinomatosis status. Methods Stent- and patient-related clinical outcomes were compared for carcinomatosis status in a retrospective review involving 323 consecutive patients (colorectal cancer 198 patients; extracolonic malignancy 125 patients) who underwent palliative SEMS placement for malignant colorectal obstruction from January 2005 to March 2012.ŠSeverity of carcinomatosis was classified as mild, moderate, or severe. Results Carcinomatosis was observed in 190 patients (58.8Š%). The rates of technical (84.7 vs. 94.7Š%; P Š=Š0.005) and clinical (73.2 vs. 83.5Š%; P Š=Š0.03) success were lower in patients with vs. without carcinomatosis. Rates of early (2.1Š% vs. 3.0Š%; P Š=Š0.72) and delayed (1.6Š% vs. 6.0Š%; P Š=Š0.08) perforation and stent failure (27.9Š% vs. 26.3Š%; P Š=Š0.75) showed no difference. Technical and clinical success rates were significantly different based on the severity of carcinomatosis (technical success rate: mild 90.7Š%, moderate 97.4Š%, severe 76.3Š%, P Š=Š0.003; clinical success rate: mild 83.3Š%, moderate 82.1Š%, severe 63.9Š%, P Š=Š0.01). In multivariate analysis, severe carcinomatosis was identified as an independent factor related to technical (odds ratio [OR] 0.18, 95Š% confidence interval [CI] 0.06Š-Š0.56) and clinical (OR 0.33, 95Š%CI 0.15Š-Š0.74) success. Conclusions Peritoneal carcinomatosis was associated with decreased technical and clinical success rates in patients receiving SEMS for malignant colorectal obstruction. Moreover, the presence of severe carcinomatosis was an independent factor determining these clinical outcomes.

Original languageEnglish
Pages (from-to)1163-1174
Number of pages12
JournalEndoscopy
Volume50
Issue number12
DOIs
Publication statusPublished - 2018 Jan 1

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Carcinoma
Stents
Odds Ratio
Self Expandable Metallic Stents
Confidence Intervals
Colorectal Neoplasms
Multivariate Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Park, Jae Jun ; Rhee, Kwangwon ; Yoon, Jin Young ; Park, Soo Jung ; Kim, Joo Hee ; Kim, Jie-Hyun ; Youn, Young Hoon ; Kim, Tae Il ; Park, HyoJin ; Kim, Won Ho ; Cheon, JaeHee. / Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction. In: Endoscopy. 2018 ; Vol. 50, No. 12. pp. 1163-1174.
@article{425933dbe9e94a6bb62aa6e0c2e6feb2,
title = "Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction",
abstract = "Background Peritoneal carcinomatosis can influence clinical outcomes of patients receiving self-expandable metal stents (SEMS) for malignant colorectal obstruction, but data regarding this issue are sparse. We analyzed the clinical outcomes of post-SEMS insertion for malignant colorectal obstruction based on carcinomatosis status. Methods Stent- and patient-related clinical outcomes were compared for carcinomatosis status in a retrospective review involving 323 consecutive patients (colorectal cancer 198 patients; extracolonic malignancy 125 patients) who underwent palliative SEMS placement for malignant colorectal obstruction from January 2005 to March 2012.ŠSeverity of carcinomatosis was classified as mild, moderate, or severe. Results Carcinomatosis was observed in 190 patients (58.8Š{\%}). The rates of technical (84.7 vs. 94.7Š{\%}; P Š=Š0.005) and clinical (73.2 vs. 83.5Š{\%}; P Š=Š0.03) success were lower in patients with vs. without carcinomatosis. Rates of early (2.1Š{\%} vs. 3.0Š{\%}; P Š=Š0.72) and delayed (1.6Š{\%} vs. 6.0Š{\%}; P Š=Š0.08) perforation and stent failure (27.9Š{\%} vs. 26.3Š{\%}; P Š=Š0.75) showed no difference. Technical and clinical success rates were significantly different based on the severity of carcinomatosis (technical success rate: mild 90.7Š{\%}, moderate 97.4Š{\%}, severe 76.3Š{\%}, P Š=Š0.003; clinical success rate: mild 83.3Š{\%}, moderate 82.1Š{\%}, severe 63.9Š{\%}, P Š=Š0.01). In multivariate analysis, severe carcinomatosis was identified as an independent factor related to technical (odds ratio [OR] 0.18, 95Š{\%} confidence interval [CI] 0.06Š-Š0.56) and clinical (OR 0.33, 95Š{\%}CI 0.15Š-Š0.74) success. Conclusions Peritoneal carcinomatosis was associated with decreased technical and clinical success rates in patients receiving SEMS for malignant colorectal obstruction. Moreover, the presence of severe carcinomatosis was an independent factor determining these clinical outcomes.",
author = "Park, {Jae Jun} and Kwangwon Rhee and Yoon, {Jin Young} and Park, {Soo Jung} and Kim, {Joo Hee} and Jie-Hyun Kim and Youn, {Young Hoon} and Kim, {Tae Il} and HyoJin Park and Kim, {Won Ho} and JaeHee Cheon",
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doi = "10.1055/a-0657-3764",
language = "English",
volume = "50",
pages = "1163--1174",
journal = "Endoscopy",
issn = "0013-726X",
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Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction. / Park, Jae Jun; Rhee, Kwangwon; Yoon, Jin Young; Park, Soo Jung; Kim, Joo Hee; Kim, Jie-Hyun; Youn, Young Hoon; Kim, Tae Il; Park, HyoJin; Kim, Won Ho; Cheon, JaeHee.

In: Endoscopy, Vol. 50, No. 12, 01.01.2018, p. 1163-1174.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction

AU - Park, Jae Jun

AU - Rhee, Kwangwon

AU - Yoon, Jin Young

AU - Park, Soo Jung

AU - Kim, Joo Hee

AU - Kim, Jie-Hyun

AU - Youn, Young Hoon

AU - Kim, Tae Il

AU - Park, HyoJin

AU - Kim, Won Ho

AU - Cheon, JaeHee

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background Peritoneal carcinomatosis can influence clinical outcomes of patients receiving self-expandable metal stents (SEMS) for malignant colorectal obstruction, but data regarding this issue are sparse. We analyzed the clinical outcomes of post-SEMS insertion for malignant colorectal obstruction based on carcinomatosis status. Methods Stent- and patient-related clinical outcomes were compared for carcinomatosis status in a retrospective review involving 323 consecutive patients (colorectal cancer 198 patients; extracolonic malignancy 125 patients) who underwent palliative SEMS placement for malignant colorectal obstruction from January 2005 to March 2012.ŠSeverity of carcinomatosis was classified as mild, moderate, or severe. Results Carcinomatosis was observed in 190 patients (58.8Š%). The rates of technical (84.7 vs. 94.7Š%; P Š=Š0.005) and clinical (73.2 vs. 83.5Š%; P Š=Š0.03) success were lower in patients with vs. without carcinomatosis. Rates of early (2.1Š% vs. 3.0Š%; P Š=Š0.72) and delayed (1.6Š% vs. 6.0Š%; P Š=Š0.08) perforation and stent failure (27.9Š% vs. 26.3Š%; P Š=Š0.75) showed no difference. Technical and clinical success rates were significantly different based on the severity of carcinomatosis (technical success rate: mild 90.7Š%, moderate 97.4Š%, severe 76.3Š%, P Š=Š0.003; clinical success rate: mild 83.3Š%, moderate 82.1Š%, severe 63.9Š%, P Š=Š0.01). In multivariate analysis, severe carcinomatosis was identified as an independent factor related to technical (odds ratio [OR] 0.18, 95Š% confidence interval [CI] 0.06Š-Š0.56) and clinical (OR 0.33, 95Š%CI 0.15Š-Š0.74) success. Conclusions Peritoneal carcinomatosis was associated with decreased technical and clinical success rates in patients receiving SEMS for malignant colorectal obstruction. Moreover, the presence of severe carcinomatosis was an independent factor determining these clinical outcomes.

AB - Background Peritoneal carcinomatosis can influence clinical outcomes of patients receiving self-expandable metal stents (SEMS) for malignant colorectal obstruction, but data regarding this issue are sparse. We analyzed the clinical outcomes of post-SEMS insertion for malignant colorectal obstruction based on carcinomatosis status. Methods Stent- and patient-related clinical outcomes were compared for carcinomatosis status in a retrospective review involving 323 consecutive patients (colorectal cancer 198 patients; extracolonic malignancy 125 patients) who underwent palliative SEMS placement for malignant colorectal obstruction from January 2005 to March 2012.ŠSeverity of carcinomatosis was classified as mild, moderate, or severe. Results Carcinomatosis was observed in 190 patients (58.8Š%). The rates of technical (84.7 vs. 94.7Š%; P Š=Š0.005) and clinical (73.2 vs. 83.5Š%; P Š=Š0.03) success were lower in patients with vs. without carcinomatosis. Rates of early (2.1Š% vs. 3.0Š%; P Š=Š0.72) and delayed (1.6Š% vs. 6.0Š%; P Š=Š0.08) perforation and stent failure (27.9Š% vs. 26.3Š%; P Š=Š0.75) showed no difference. Technical and clinical success rates were significantly different based on the severity of carcinomatosis (technical success rate: mild 90.7Š%, moderate 97.4Š%, severe 76.3Š%, P Š=Š0.003; clinical success rate: mild 83.3Š%, moderate 82.1Š%, severe 63.9Š%, P Š=Š0.01). In multivariate analysis, severe carcinomatosis was identified as an independent factor related to technical (odds ratio [OR] 0.18, 95Š% confidence interval [CI] 0.06Š-Š0.56) and clinical (OR 0.33, 95Š%CI 0.15Š-Š0.74) success. Conclusions Peritoneal carcinomatosis was associated with decreased technical and clinical success rates in patients receiving SEMS for malignant colorectal obstruction. Moreover, the presence of severe carcinomatosis was an independent factor determining these clinical outcomes.

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U2 - 10.1055/a-0657-3764

DO - 10.1055/a-0657-3764

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SP - 1163

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JO - Endoscopy

JF - Endoscopy

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