Ten-year survival after endoscopic stent placement as a bridge to surgery in obstructing colon cancer
| Autor: | Annelien Van Driessche, Bram Verstockt, Pieter Dobbels, Koen Hendrickx, Jo Vandervoort, Yves Van Molhem, Veerle Casneuf, Pieter Van der Spek, Marc De Man |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Colon medicine.medical_treatment Perforation (oil well) Self Expandable Metallic Stents 03 medical and health sciences 0302 clinical medicine Postoperative Complications Belgium Colon surgery medicine Humans Radiology Nuclear Medicine and imaging Endoscopic stenting Prospective Studies Registries Adverse effect Prospective cohort study Survival rate Aged Aged 80 and over business.industry General surgery Gastroenterology Stent Colonoscopy Middle Aged medicine.disease Surgery Survival Rate Treatment Outcome 030220 oncology & carcinogenesis Colonic Neoplasms 030211 gastroenterology & hepatology Female business Intestinal Obstruction |
| Zdroj: | Gastrointestinal endoscopy. 87(3) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Self-expandable metal stents are used increasingly in the treatment of obstructing colorectal cancer (CRC). Although endoscopic colon stenting is widely accepted in palliation, disagreement exists about its role in a curative setting. This study aims to describe long-term survival data in a large patient group treated with colon stenting as a bridge to surgery for CRC. Methods This prospective study included 97 patients who presented in a Belgian hospital between 1998 and 2013 with obstructing, although potentially curable, CRC. All patients underwent endoscopic stenting as a bridge to surgery. Procedure-related adverse events and long-term follow-up data were retrospectively collected and compared with the CRC mortality in Belgium in the same time span. Results Overall survival in this observational cohort did not differ significantly from survival in all Belgian patients with CRC in the same period ( P = .14). One-year, 5-year, and 10-year survival rates were similar in both groups (95.9% vs 79.0%; 54.7% vs 51.2%; 41.0% vs 35.6%, respectively). The technical success rate was 94.8%. Seventy-three patients did not experience any adverse event. Stent migration occurred in 9 patients, whereas micro-perforations and macro-perforations were observed in 14 patients, without influence on survival. Incidence rates of peritoneal metastases did not differ between patients with and without any type of perforation (22.2% vs 15.2%, respectively; P = .47). The type of stent influenced the overall adverse event risk, mainly driven by a significant increase in stent migration in case of Wallstent enteral (Boston Scientific Corporation, Natick, Mass). Conclusions Colon stenting before surgery is effective and did not worsen the survival outcome in patients with obstructing CRC who were treated with curative intent, which affirms the role for stenting as a bridge to surgery. |
| Databáze: | OpenAIRE |
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