Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction

Comparison with nonobstructing elective surgery

Jin Soo Kim, Hyuk Hur, Byung Soh Min, Seung Kook Sohn, Chang Hwan Cho, Namkyu Kim

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Background: Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobstructing elective surgery. Methods: Between October 1999 and July 2007, 35 patients who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 patients who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B). Group B was randomly extracted from the colorectal database of our institute. The two groups were compared for clinicopathologic variables, complications, and survival rate. Results: There were no significant differences in clinicopathologic variables between group A and group B. However, the stoma formation rate was statistically different between the two groups (p = 0.003). Self-expanding metallic stent insertion had an adverse effect on the 5-year overall survival rate (A vs. B, 38.4% vs. 65.6%, respectively; p = 0.025) and the 5-year disease-free survival rate (A vs. B, 48.3% vs. 75.5%, respectively; p = 0.024). Conclusions: These data show that insertion of SEMS as a bridge to surgery in the management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to the underlying obstruction rather than to the SEMS.

Original languageEnglish
Pages (from-to)1281-1286
Number of pages6
JournalWorld Journal of Surgery
Volume33
Issue number6
DOIs
Publication statusPublished - 2009 Jun 1

Fingerprint

Colonic Neoplasms
Stents
Survival Rate
Neoplasms
Disease-Free Survival
Colorectal Neoplasms
Colon
Databases
Safety

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{94e1da5782b94ac6b29d24719961c514,
title = "Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: Comparison with nonobstructing elective surgery",
abstract = "Background: Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobstructing elective surgery. Methods: Between October 1999 and July 2007, 35 patients who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 patients who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B). Group B was randomly extracted from the colorectal database of our institute. The two groups were compared for clinicopathologic variables, complications, and survival rate. Results: There were no significant differences in clinicopathologic variables between group A and group B. However, the stoma formation rate was statistically different between the two groups (p = 0.003). Self-expanding metallic stent insertion had an adverse effect on the 5-year overall survival rate (A vs. B, 38.4{\%} vs. 65.6{\%}, respectively; p = 0.025) and the 5-year disease-free survival rate (A vs. B, 48.3{\%} vs. 75.5{\%}, respectively; p = 0.024). Conclusions: These data show that insertion of SEMS as a bridge to surgery in the management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to the underlying obstruction rather than to the SEMS.",
author = "Kim, {Jin Soo} and Hyuk Hur and Min, {Byung Soh} and Sohn, {Seung Kook} and Cho, {Chang Hwan} and Namkyu Kim",
year = "2009",
month = "6",
day = "1",
doi = "10.1007/s00268-009-0007-5",
language = "English",
volume = "33",
pages = "1281--1286",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",
number = "6",

}

Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction : Comparison with nonobstructing elective surgery. / Kim, Jin Soo; Hur, Hyuk; Min, Byung Soh; Sohn, Seung Kook; Cho, Chang Hwan; Kim, Namkyu.

In: World Journal of Surgery, Vol. 33, No. 6, 01.06.2009, p. 1281-1286.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction

T2 - Comparison with nonobstructing elective surgery

AU - Kim, Jin Soo

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Sohn, Seung Kook

AU - Cho, Chang Hwan

AU - Kim, Namkyu

PY - 2009/6/1

Y1 - 2009/6/1

N2 - Background: Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobstructing elective surgery. Methods: Between October 1999 and July 2007, 35 patients who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 patients who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B). Group B was randomly extracted from the colorectal database of our institute. The two groups were compared for clinicopathologic variables, complications, and survival rate. Results: There were no significant differences in clinicopathologic variables between group A and group B. However, the stoma formation rate was statistically different between the two groups (p = 0.003). Self-expanding metallic stent insertion had an adverse effect on the 5-year overall survival rate (A vs. B, 38.4% vs. 65.6%, respectively; p = 0.025) and the 5-year disease-free survival rate (A vs. B, 48.3% vs. 75.5%, respectively; p = 0.024). Conclusions: These data show that insertion of SEMS as a bridge to surgery in the management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to the underlying obstruction rather than to the SEMS.

AB - Background: Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobstructing elective surgery. Methods: Between October 1999 and July 2007, 35 patients who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 patients who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B). Group B was randomly extracted from the colorectal database of our institute. The two groups were compared for clinicopathologic variables, complications, and survival rate. Results: There were no significant differences in clinicopathologic variables between group A and group B. However, the stoma formation rate was statistically different between the two groups (p = 0.003). Self-expanding metallic stent insertion had an adverse effect on the 5-year overall survival rate (A vs. B, 38.4% vs. 65.6%, respectively; p = 0.025) and the 5-year disease-free survival rate (A vs. B, 48.3% vs. 75.5%, respectively; p = 0.024). Conclusions: These data show that insertion of SEMS as a bridge to surgery in the management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to the underlying obstruction rather than to the SEMS.

UR - http://www.scopus.com/inward/record.url?scp=67349092085&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67349092085&partnerID=8YFLogxK

U2 - 10.1007/s00268-009-0007-5

DO - 10.1007/s00268-009-0007-5

M3 - Article

VL - 33

SP - 1281

EP - 1286

JO - World Journal of Surgery

JF - World Journal of Surgery

SN - 0364-2313

IS - 6

ER -