Ten-year survival after endoscopic stent placement as a bridge to surgery in obstructing colon cancer

Verstockt, Bram; Driessche, Annelien Van; Man, Marc De; Spek, Pieter van der; Hendrickx, Koen; Casneuf, Veerle; Dobbels, Pieter; Molhem, Yves Van; Vandervoort, Jo

doi:10.1016/j.gie.2017.05.032

Cited by 36 publications

(40 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They concluded that the best treatment option for left-sided MCOs is a BTS in centers with the appropriate skill 40) . Belgian prospective 10year survival data after endoscopic stent placement as a BTS in patients with obstructive colon cancer showed that colon stenting before surgery was effective and did not have a negative effect on survival outcomes when the patients were treated with curative intent 41) . However, such evidence is not suitable to change the ESGE Clinical Guidance, and further randomized, controlled studies are needed to compare survival after stenting with that after primary resection.…”

Section: Long-term Outcomes Of Colonic Stentsmentioning

confidence: 99%

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Saida

2019

J Anus Rectum Colon

View full text Add to dashboard Cite

Colorectal cancer is the most common cancer in Japan. Approximately 10%-20% of the patients with colorectal cancer present with large bowel obstruction, and those who present with malignant colonic obstruction (MCO) require urgent decompression because MCO can cause electrolytic fluid imbalance, colonic necrosis, bacterial translocation, and death. Placement of colonic stents (self-expandable metallic stents) for MCO is a major and standard endoscopic treatment that has been available since 2012 in Japan. This review presents the current conditions and future prospects of this procedure based on the literature. The current indication of colonic stent placement is malignant colorectal stenosis. One of the purposes of using stents is palliative treatment; further, its advantages over emergency surgery with colostomy include avoidance of colostomy, relief of obstruction, shorter hospitalization, and better quality of life. In addition, stent placement can also be used as a bridge to surgery since the duration of the hospitalization is shorter and postoperative complications, colostomy rates, and mortality rates are lower with elective than with emergency surgery. Although recent studies have reported low complication rates related to colonic stents, complications may still occur, highlighting the importance of good preparation, adequate staffing, backup systems, and informed consent. The current major problem related to colonic stents is the lack of evidence on patients' long-term prognoses for bridge to surgery purposes, awaiting the results of ongoing clinical research.

show abstract

Section: Long-term Outcomes Of Colonic Stentsmentioning

confidence: 99%

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Saida

2019

J Anus Rectum Colon

View full text Add to dashboard Cite

show abstract

“…14,16 Moreover, air insufflation during the procedure is considered a risk factor for bowel perforation. 20 Therefore, given these facts, we thought that it is very important to shorten the procedure time and identify the risk factors for such difficult cases. However, previous studies have only compared cases based on outcome.…”

Section: Introductionmentioning

confidence: 99%

Factors related to difficult self‐expandable metallic stent placement for malignant colonic obstruction: A post‐hoc analysis of a multicenter study across Japan

Kuwai

Yamaguchi

Imagawa

et al. 2018

Digestive Endoscopy

View full text Add to dashboard Cite

show abstract

“…A multicentre retrospective study also indicated that the long-term oncologic outcome of the SEMS group was similar or slightly better than that of the ES group among all patients with stage II or III colon cancer [23]. Moreover, a recent study reported that SEMS placement increased plasma levels of cell-free DNA and circulating tumour DNA by tumour manipulation [24], although several clinical studies reported no signi cant differences in the long-term survival rates regardless of stent placement before surgery [25,26]. Moreover, Li et al and Gianotti et al reported improved survival of the SEMS group throughout the follow-up period [27,28].…”

Section: Discussionmentioning

confidence: 99%

Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction

Cai

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Data are limited regarding the advantages of a self-expandable metal stent (SEMS) as a bridge to elective surgery for acute malignant obstruction of the right-sided colon (MORC), as most studies concentrated on this technique used in left-sided colon. This study aimed to evaluate the outcomes of patients (including stage IV cases) with acute MORC treated by initial SEMS placement vs emergency surgery (ES). Methods Patients with acute MORC who underwent radical resection for a primary tumour from July 2008 to November 2016 at Zhongshan Hospital of Fudan University were retrospectively enrolled. Postoperative short-term outcomes, progression-free survival (PFS), and overall survival (OS) were compared between the SEMS and ES groups. Results In total, 107 patients with acute MORC (35 in the SEMS group and 72 in the ES group) were included for analysis. The Intensive Care Unit admission rate was lower (11.4% vs. 34.7%, P = 0.011), the incidence of complications was reduced (11.4% vs. 29.2%, P = 0.042), and the postoperative length of hospitalisation was significantly shorter (8.23 ± 6.50 vs. 11.18 ± 6.71 days, P = 0.033) for the SEMS group. Survival curves showed no significant difference in PFS (P = 0.506) or OS (P = 0.989) between groups. 29.0% (27/93) of the patients with stage II and III disease experienced disease progression, when the distant metastasis rates for the SEMS and ES groups were 21.4% (6/28) and 18.5% (12/65), respectively (P = 0.740) and local site relapse presented in 2 (7.1%) patients of the SEMS group and in 7 (10.8%) patients of the ES group (P = 0.719). After colectomy for synchronous liver metastases, the hepatectomy rates for the SEMS and ES groups were 85.7% and 14.3%, respectively (P = 0.029). The hazard ratio for colectomy alone vs combined resection was 3.258 (95% CI 0.858–12.370; P = 0.041). Conclusion Stent placement offers significant advantages in terms of short-term outcomes and comparable prognoses for acute MORC patients. For synchronous liver metastases, SEMS placement better prepares the patient for resection of the primary tumour and liver metastasis, which contribute to improved survival.

show abstract

Ten-year survival after endoscopic stent placement as a bridge to surgery in obstructing colon cancer

Cited by 36 publications

References 32 publications

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Current status of colonic stent for obstructive colorectal cancer in Japan; a review of the literature

Factors related to difficult self‐expandable metallic stent placement for malignant colonic obstruction: A post‐hoc analysis of a multicenter study across Japan

Self-expandable metallic stenting as a bridge to elective surgery versus emergency surgery for acute malignant right-sided colorectal obstruction

Contact Info

Product

Resources

About