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World Journal of Surgery

Published in:

01-06-2009

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

Authors: Jin Soo Kim, Hyuk Hur, Byung Soh Min, Seung Kook Sohn, Chang Hwan Cho, Nam Kyu Kim

Published in: World Journal of Surgery | Issue 6/2009

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.

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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
Authors: Jin Soo Kim
Hyuk Hur
Byung Soh Min
Seung Kook Sohn
Chang Hwan Cho
Nam Kyu Kim
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-0007-5

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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

Methods

Results

Conclusions

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Abstract

Background

Methods

Results

Conclusions

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