{"title":"阻塞性结直肠癌患者从支架植入到手术间隔时间的肿瘤学调查。","authors":"Shintaro Kanaka, Akihisa Matsuda, Takeshi Yamada, Yasuyuki Yokoyama, Satoshi Matsumoto, Goro Takahashi, Hiromichi Sonoda, Ryo Ohta, Kay Uehara, Seiichi Shinji, Takuma Iwai, Kohki Takeda, Kumiko Sekiguchi, Sho Kuriyama, Toshimitsu Miyasaka, Hiroshi Yoshida","doi":"10.1007/s00595-024-02818-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking.</p><p><strong>Methods: </strong>We retrospectively collected data from patients with BTS between January 2013 and October 2021. Inverse probability treatment-weighted propensity score analyses were used to compare short- and long-term outcomes between the short-interval (SI) and long-interval (LI) groups, using a cutoff of 20 days.</p><p><strong>Results: </strong>In total, 138 patients were enrolled in this study (SI group, n = 63; LI group, n = 75). In the matched cohort, the patients' backgrounds were well balanced. The incidence of Clavien-Dindo grade ≥ II postoperative complications was not significantly different between the SI and LI groups (19.0% vs. 14.0%, P = 0.47). There were no significant differences between the SI and LI groups in the 3-year recurrence-free survival (68.0% vs. 76.4%, P = 0.73) or 3-year overall survival rates (86.0% vs. 90.6%, P = 0.72).</p><p><strong>Conclusions: </strong>A longer interval did not deteriorate the oncological outcomes. Individual perioperative management with an appropriate interval to improve the patient's condition is required to ensure safe surgery.</p>","PeriodicalId":22163,"journal":{"name":"Surgery Today","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oncologic investigation of the interval from stent placement to surgery in patients with obstructive colorectal cancer.\",\"authors\":\"Shintaro Kanaka, Akihisa Matsuda, Takeshi Yamada, Yasuyuki Yokoyama, Satoshi Matsumoto, Goro Takahashi, Hiromichi Sonoda, Ryo Ohta, Kay Uehara, Seiichi Shinji, Takuma Iwai, Kohki Takeda, Kumiko Sekiguchi, Sho Kuriyama, Toshimitsu Miyasaka, Hiroshi Yoshida\",\"doi\":\"10.1007/s00595-024-02818-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking.</p><p><strong>Methods: </strong>We retrospectively collected data from patients with BTS between January 2013 and October 2021. Inverse probability treatment-weighted propensity score analyses were used to compare short- and long-term outcomes between the short-interval (SI) and long-interval (LI) groups, using a cutoff of 20 days.</p><p><strong>Results: </strong>In total, 138 patients were enrolled in this study (SI group, n = 63; LI group, n = 75). In the matched cohort, the patients' backgrounds were well balanced. The incidence of Clavien-Dindo grade ≥ II postoperative complications was not significantly different between the SI and LI groups (19.0% vs. 14.0%, P = 0.47). There were no significant differences between the SI and LI groups in the 3-year recurrence-free survival (68.0% vs. 76.4%, P = 0.73) or 3-year overall survival rates (86.0% vs. 90.6%, P = 0.72).</p><p><strong>Conclusions: </strong>A longer interval did not deteriorate the oncological outcomes. Individual perioperative management with an appropriate interval to improve the patient's condition is required to ensure safe surgery.</p>\",\"PeriodicalId\":22163,\"journal\":{\"name\":\"Surgery Today\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery Today\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00595-024-02818-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery Today","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00595-024-02818-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的:自膨胀金属支架(SEMS)置入术被广泛用作阻塞性结直肠癌的手术桥(BTS)。然而,关于 SEMS 置入与择期手术之间的最佳间隔时间尚缺乏证据:我们回顾性地收集了2013年1月至2021年10月期间BTS患者的数据。采用反概率治疗加权倾向评分分析比较短间隔组(SI)和长间隔组(LI)的短期和长期预后,以20天为分界线:本研究共纳入 138 名患者(SI 组,n = 63;LI 组,n = 75)。在配对队列中,患者的背景非常均衡。SI组和LI组的Clavien-Dindo≥II级术后并发症发生率无显著差异(19.0% vs. 14.0%,P = 0.47)。SI组和LI组的3年无复发生存率(68.0% vs. 76.4%,P = 0.73)和3年总生存率(86.0% vs. 90.6%,P = 0.72)无明显差异:结论:较长的间隔期不会恶化肿瘤治疗效果。为确保手术安全,需要在适当的间隔期内进行个性化围手术期管理,以改善患者的状况。
Oncologic investigation of the interval from stent placement to surgery in patients with obstructive colorectal cancer.
Purpose: Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking.
Methods: We retrospectively collected data from patients with BTS between January 2013 and October 2021. Inverse probability treatment-weighted propensity score analyses were used to compare short- and long-term outcomes between the short-interval (SI) and long-interval (LI) groups, using a cutoff of 20 days.
Results: In total, 138 patients were enrolled in this study (SI group, n = 63; LI group, n = 75). In the matched cohort, the patients' backgrounds were well balanced. The incidence of Clavien-Dindo grade ≥ II postoperative complications was not significantly different between the SI and LI groups (19.0% vs. 14.0%, P = 0.47). There were no significant differences between the SI and LI groups in the 3-year recurrence-free survival (68.0% vs. 76.4%, P = 0.73) or 3-year overall survival rates (86.0% vs. 90.6%, P = 0.72).
Conclusions: A longer interval did not deteriorate the oncological outcomes. Individual perioperative management with an appropriate interval to improve the patient's condition is required to ensure safe surgery.
期刊介绍:
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.