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

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Colorectal Neoplasms
Survival
Disease-Free Survival
Korea
Self Expandable Metallic Stents
Length of Stay
Neoplasms
Emergencies
Multivariate Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Park, Jihye ; Lee, Hyun Jung ; Park, Soo Jung ; Hur, Hyuk ; Min, Byung Soh ; Cheon, Jae Hee ; Kim, Tae Il ; Kim, Nam Kyu ; Kim, Won Ho. / Long-term outcomes after stenting as a bridge to surgery in patients with obstructing left-sided colorectal cancer. In: International Journal of Colorectal Disease. 2018 ; Vol. 33, No. 6. pp. 799-807.
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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.",
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Long-term outcomes after stenting as a bridge to surgery in patients with obstructing left-sided colorectal cancer. / Park, Jihye; Lee, Hyun Jung; Park, Soo Jung; Hur, Hyuk; Min, Byung Soh; Cheon, Jae Hee; Kim, Tae Il; Kim, Nam Kyu; Kim, Won Ho.

In: International Journal of Colorectal Disease, Vol. 33, No. 6, 01.06.2018, p. 799-807.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes after stenting as a bridge to surgery in patients with obstructing left-sided colorectal cancer

AU - Park, Jihye

AU - Lee, Hyun Jung

AU - Park, Soo Jung

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Cheon, Jae Hee

AU - Kim, Tae Il

AU - Kim, Nam Kyu

AU - Kim, Won Ho

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

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