The Clinical Outcomes of Preoperative Self-Expandable Metal Stent Placement as Bridge to Surgery for Obstructive Colorectal Cancer

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-06-16 DOI:10.1002/cnr2.70255

Ryosuke Aoki, Nao Hondo, Masato Kitazawa, Satoshi Nakamura, Makoto Koyama, Masahiro Kataoka, Hirokazu Tanaka, Takuya Iguchi, Yonghan Park, Yuji Soejima

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Abstract

Background

Self-expandable metal stent (SEMS) placement for obstructive colorectal cancer (OCRC) is widely performed as a bridge to surgery because of its lower mortality rate than emergency surgery. However, the long-term outcomes remain unclear because of the risk of complications and cancer recurrence. This study investigated the short- and long-term outcomes of SEMS placement for OCRC.

Methods and Results

We retrospectively reviewed the clinicopathological data of patients with OCRC who underwent preoperative treatment and tumor resection at our institution between April 2004 and March 2022. Among 113 patients with OCRC, 30 underwent SEMS placement (Group S) and 36 underwent ileus tube insertion (Group T); Group S had more older patients and fewer pT4 cases; no other characteristics differed. Incidence of severe complications was 0% versus 16.7% (p < 0.01); postoperative hospital stay was 14.3 versus 26.6 days (p < 0.01); medical costs were comparable between the groups. The long-term outcomes of Group S and patients with non-OCRC who underwent surgery during the same period were compared after propensity score matching. The 5-year survival rates were 69.5% and 77.1%; the 5-year recurrence-free survival rates were 44.5% and 55.5%, without significant difference.

Conclusion

In conclusion, SEMS placement was more effective than ileus tube placement in treating OCRC.

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梗阻性结直肠癌术前自扩金属支架置入术过渡手术的临床效果

背景：自膨胀金属支架（SEMS）置入术治疗梗阻性结直肠癌（OCRC），由于其死亡率低于急诊手术，被广泛应用于外科手术。然而，由于并发症和癌症复发的风险，长期结果尚不清楚。本研究调查了在OCRC中放置SEMS的短期和长期结果。方法与结果回顾性分析2004年4月至2022年3月在我院接受术前治疗和肿瘤切除术的OCRC患者的临床病理资料。113例OCRC患者中，30例行SEMS置入（S组），36例行肠梗阻管置入（T组）；S组老年患者较多，pT4病例较少；没有其他特征不同。严重并发症发生率为0%比16.7% (p < 0.01)；术后住院时间14.3天对26.6天（p < 0.01）；两组之间的医疗费用相当。倾向评分匹配后，比较S组和同期行手术的非ocrc患者的长期预后。5年生存率分别为69.5%和77.1%；5年无复发生存率分别为44.5%和55.5%，差异无统计学意义。结论SEMS置管治疗OCRC的效果优于肠梗阻管置管。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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