エンドウ　シュンジ   Shunji Endo   遠藤　俊治    所属   川崎医科大学  医学部 臨床医学　消化器外科学    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Bridge to surgery using a self-expandable metallic stent for stages II-III obstructive colorectal cancer.
掲載誌名	正式名：BMC surgery 略　 称：BMC Surg ISSNコード：14712482/14712482
掲載区分	国外
巻・号・頁	20(1),pp.189
著者・共著者	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
発行年月	2020/08
概要	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