Long-term outcomes after stenting as a bridge to surgery in patients with obstructing left-sided colorectal cancer

Jihye Park, Hyun Jung Lee, Soo Jung Park, Hyuk Hur, Byung Soh Min, Jae Hee Cheon, Tae Il Kim, Nam Kyu Kim, Won Ho Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Self-expandable metallic stents (SEMS) may be used in acute, obstructing, left-sided colorectal cancer (CRC) to avoid high-risk emergency surgery. However, the data regarding the long-term effects of SEMS as a bridge to surgery are limited and contradictory. Our aim is to analyze the long-term oncological outcomes of SEMS compared with surgery. Methods: Between January 2006 and November 2013, a total of 855 patients with stage III CRC were regularly followed at the CRC clinic of Severance Hospital, Seoul, Korea. We retrospectively evaluated their 5-year disease-free survival (DFS), 5-year overall survival (OS), and 5-year cancer-specific survival (CSS). Results: There were 94 patients in the SEMS group, 17 in the emergent-surgery group, and 744 in the elective-surgery group. In the short term, the rate of permanent stoma formation was significantly higher in the emergent-surgery group than in the SEMS group (p = 0.030), although the median hospital stay and overall complication rate were comparable. During the long-term follow-up period, oncological outcomes including 5-year DFS (70.2 vs 52.9%; p = 0.210), OS (70.2 vs 52.9%; p = 0.148), and CSS (79.8 vs 70.6%; p = 0.342) were not different between the SEMS group and the emergent-surgery group. Multivariate analysis showed emergent operation to be a significant risk factor of DFS (hazard ratio [HR], 3.117; 95% confidence interval [CI], 1.498–6.489; p = 0.002). Conclusions: Preoperative SEMS insertion does not adversely affect long-term oncological outcomes or patient survival.

Original languageEnglish
Pages (from-to)799-807
Number of pages9
JournalInternational Journal of Colorectal Disease
Volume33
Issue number6
DOIs
Publication statusPublished - 2018 Jun 1

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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