Comparison of the long-term oncological outcomes of stent as a bridge to surgery and surgery alone in malignant colonic obstruction

Udit Gibor, Zvi H. Perry, Dan Tirosh, Uri Netz, Alex Rosental, Alex Fich, Sofie Man, Samuel Ariad, Boris Kirshtein

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Self-expanding metallic stents (SEMS) insertion is an alternative to emergency surgery in malignant colonic obstruction. However, the long-term oncological outcome of stents as a bridge to surgery is limited and controversial. Objectives: To determine the long-term oncological outcome of stents as a bridge to surgery. Methods: Data of patients who underwent emergency surgery and endoscopic stent insertion as a bridge to surgery due to obstructing colonic cancer at Soroka Medical Center during a 14 year period were collected retrospectively. Preoperative data, tumor staging, and oncological outcomes in terms of local recurrence, metastatic spread, and overall survival of the patients were compared. Results: Sixty-four patients (56% female, mean age 72 years) were included in the study: 43 (67%) following emergency surgery, 21 stent inserted prior to surgery. A stent was inserted within 24–48 hours of hospital admission. The mean time between SEMS insertion and surgery was 15 days (range 0–30). Most of the patients had stage II (41%) and stage III (34%) colon cancer. There was no difference in tumor staging and localization between groups. There was no significant difference in disease recurrence between SEMS and surgery groups, 24% and 32%, respectively. Disease-free survival rates were similar between the SEMS group (23.8%) and surgery group (22%). Four year and overall survival rates were 52.4% vs. 47.6%, 33.3% vs. 39.5%, respectively. Conclusions: SEMS as a bridge to surgery in patients with obstructing colon cancer provide an equivalent long-term oncological outcome to surgery alone.

Original languageEnglish
Pages (from-to)736-740
Number of pages5
JournalIsrael Medical Association Journal
Volume19
Issue number12
StatePublished - Dec 2017
Externally publishedYes

Keywords

  • Colon cancer
  • Colonic obstruction
  • Endoscopic stent
  • Self-expanding metallic stents (SEMS)

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