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 journalArticlepeer-review

4 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

Bibliographical note

Funding Information:
The authors thank native English-speaking experts from BioMed Proofreading? LLC for the editing. Informed consent was obtained from all patients before the procedure. This study was approved by the institutional review board of Severance Hospital, Yonsei University (Seoul, Korea) and was conducted in accordance with the ethical principles of the Declaration of Helsinki

Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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