Shunji Endo
Department Kawasaki Medical School Kawasaki Medical School, Department of Digestive Surgery, Position Associate Professor |
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Article types | 原著 |
Language | English |
Peer review | Peer reviewed |
Title | Bridge to surgery using a self-expandable metallic stent for stages II-III obstructive colorectal cancer. |
Journal | Formal name:BMC surgery Abbreviation:BMC Surg ISSN code:14712482/14712482 |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 20(1),pp.189 |
Author and coauthor | Ohta Katsuya, Ikenaga Masakazu, Ueda Masami, Iede Kiyotsugu, Tsuda Yujiro, Nakashima Shinsuke, Nojiri Takashi, Matsuyama Jin, Endo Shunji, Murata Jun, Kobayashi Ichizo, Tsujii Masahiko, Yamada Terumasa |
Publication date | 2020/08 |
Summary | BACKGROUND:Bridge to surgery (BTS) using a self-expandable metallic stent (SEMS) for the treatment of obstructive colorectal cancer improves the patient's quality of life. This study aimed to examine prognostic factors of obstructive colorectal cancer.METHODS:We analyzed stage II-III resectable colon cancer cases (Cur A) retrospectively registered between January 2005 and December 2017. Overall, 117 patients with Cur A obstructive colorectal cancer were evaluated: 67 of them underwent emergency surgery (ES Group) and 50 of them after BTS with SEMS placement (BTS group). We compared surgical results and prognoses between the two groups.RESULTS:A total of 50 patients underwent endoscopic SEMS placement, which technical success of 96% and morbidity rate of 18%. Primary anastomosis rates were 77.6% in ES and 95.7% in BTS (p < 0.001); postoperative complication, 46.3% in ES and 10.5% in BTS (p < 0.001); pathological findings of lymphatic invasion, 66.7% in ES and 100% in BTS (p < 0.001); venous invasion were 66.8% in ES and 92% in BTS (p = 0.04); and recurrence of 25.4% in ES and 39.1% in BTS. The 3-year overall survival was significantly different between two groups (ES, 86.8%:BTS, 58.8%), BTS is worse than ES (log-rank test; p < 0.001). Venous invasion independently predicted worsened recurrence-free and overall survival.CONCLUSIONS:The vascular invasiveness was correlated with tumor progression after SEMS placement, and the survival rate was lower in BTS. SEMS potentially worsens prognostic outcomes in stage II-III obstructive colorectal cancer. |
DOI | 10.1186/s12893-020-00847-z |
PMID | 32819354 |