Utility and Safety of the Self-expandable Metallic Colonic Stent in Japanese Patients Who Received Systemic Chemotherapy or Palliative Treatment for Obstructive Primary Advanced Colorectal Cancer: A Retrospective Single-center Medical Chart...

Overview

Journal JGH Open

Specialty Gastroenterology

Date 2022 May 23

PMID 35601122

Authors

Naomi Naruse

Koichi Miyahara

Yasuhisa Sakata

Ayako Takamori

Yoichiro Ito

Hidenori Hidaka

Ryuichiro Sameshima

Nanae Tsuruoka

Ryo Shimoda

Kohei Yamanouchi

Takahiro Noda

Kazuma Fujimoto

Motohiro Esaki

Affiliations

Soon will be listed here.

Abstract

Background And Aim: The present study aimed to compare the utility and safety of the colonic self-expandable metallic stent between patients with obstructive primary colorectal cancer who underwent chemotherapy or palliative treatment care and patients bridging for surgery.

Methods: The cases of 71 patients with colonic obstructive stenosis and in-dwelling stents who were hospitalized between May 2012 and April 2020 at Karatsu Red Cross Hospital were retrospectively analyzed. The patients were classified into three groups: bridging for curative surgery (group I), receiving systemic chemotherapy (group II-A), and receiving only palliative treatment (group II-B). Technical and clinical success rates and complication rates after stenting were evaluated.

Results: No significant differences were observed in the technical (procedure) success rates (group I: 100%; group II, 97.6% [II-A: 100%; II-B: 95.8%]). The total clinical success rate was 85.9% (61/71) and did not vary significantly among the groups (group I: 82.8%; group II 88.0% [II-A: 83.3%; II-B: 91.6%]). No significant differences were observed in the early complication rates between groups I and II and in the late complication rates between groups II-A and II-B. Nutrition status, general condition, tumor staging, and 1-year survival were poorer in group II than in group I.

Conclusion: The findings show that colonic stenting for malignant obstruction was performed successfully and safely both in patients who received systemic chemotherapy or palliative therapy and in patients bridging for curative surgery, regardless of risk status for malnutrition, poor general condition, cancer stage progression, and short survival.

Citing Articles

A New Self-Expandable Metallic Stent with Low Axial Force and a High Axial Force Zero-Border Shows a Very Low Perforation Rate in Malignant Colorectal Obstruction: A Japanese Multicenter Prospective Study.

Murakami T, Isayama H, Ikeda S, Hanabata N, Enomoto T, Kuwai T J Clin Med. 2024; 13(17).

PMID: 39274314 PMC: 11396272. DOI: 10.3390/jcm13175102.

A Japanese Prospective, Multicenter Study of Colonic Stenting for Palliation Using a High Axial Force Self-Expandable Metal Stent for Malignant Large Bowel Obstruction in 200 Patients.

Ishibashi R, Sasaki T, Isayama H, Matsuzawa T, Kuwai T, Yamada T J Clin Med. 2023; 12(15).

PMID: 37568537 PMC: 10419878. DOI: 10.3390/jcm12155134.

References

Furuke H, Komatsu S, Ikeda J, Tanaka S, Kumano T, Imura K . Self-expandable Metallic Stents Contribute to Reducing Perioperative Complications in Colorectal Cancer Patients with Acute Obstruction. Anticancer Res. 2018; 38(3):1749-1753. DOI: 10.21873/anticanres.12411. View

Oken M, Creech R, Tormey D, Horton J, Davis T, McFadden E . Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982; 5(6):649-55. View

Sato R, Oikawa M, Kakita T, Okada T, Abe T, Yazawa T . Preoperative change of modified Glasgow prognostic score after stenting predicts the long-term outcomes of obstructive colorectal cancer. Surg Today. 2019; 50(3):232-239. DOI: 10.1007/s00595-019-01862-1. View

Morita S, Yamamoto K, Ogawa A, Naito A, Mizuno H, Yoshioka S . Benefits of using a self-expandable metallic stent as a bridge to surgery for right- and left-sided obstructive colorectal cancers. Surg Today. 2018; 49(1):32-37. DOI: 10.1007/s00595-018-1701-4. View

Watt A, Faragher I, Griffin T, Rieger N, Maddern G . Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007; 246(1):24-30. PMC: 1899207. DOI: 10.1097/01.sla.0000261124.72687.72. View

Lee Y, Yoon J, Park J, Park S, Kim J, Youn Y . Clinical outcomes and factors related to colonic perforations in patients receiving self-expandable metal stent insertion for malignant colorectal obstruction. Gastrointest Endosc. 2018; 87(6):1548-1557.e1. DOI: 10.1016/j.gie.2018.02.006. View

Cohen R, Vernerey D, Bellera C, Meurisse A, Henriques J, Paoletti X . Guidelines for time-to-event end-point definitions in adjuvant randomised trials for patients with localised colon cancer: Results of the DATECAN initiative. Eur J Cancer. 2020; 130:63-71. PMC: 7409551. DOI: 10.1016/j.ejca.2020.02.009. View

van Hooft J, Veld J, Arnold D, Beets-Tan R, Everett S, Gotz M . Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy. 2020; 52(5):389-407. DOI: 10.1055/a-1140-3017. View

Tajima J, Matsuhashi N, Takahashi T, Mizutani C, Iwata Y, Kiyama S . Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction as a bridge to surgery focus on the feasibility of the laparoscopic approach: a retrospective, single center study. World J Surg Oncol. 2020; 18(1):265. PMC: 7556958. DOI: 10.1186/s12957-020-02039-8. View

10.

Pisano M, Zorcolo L, Merli C, Cimbanassi S, Poiasina E, Ceresoli M . 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World J Emerg Surg. 2018; 13:36. PMC: 6090779. DOI: 10.1186/s13017-018-0192-3. View

11.

Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Kawano Y, Yamada T . Optimal Interval From Placement of a Self-expandable Metallic Stent to Surgery in Patients With Malignant Large Bowel Obstruction: A Preliminary Study. Surg Laparosc Endosc Percutan Tech. 2018; 28(4):239-244. DOI: 10.1097/SLE.0000000000000548. View

12.

Sato R, Oikawa M, Kakita T, Okada T, Abe T, Yazawa T . The Controlling Nutritional Status (CONUT) Score as a prognostic factor for obstructive colorectal cancer patients received stenting as a bridge to curative surgery. Surg Today. 2020; 51(1):144-152. DOI: 10.1007/s00595-020-02066-8. View

13.

Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Kawano Y, Yamahatsu K . Colonic stent-induced mechanical compression may suppress cancer cell proliferation in malignant large bowel obstruction. Surg Endosc. 2018; 33(4):1290-1297. DOI: 10.1007/s00464-018-6411-x. View

14.

Shimizu H, Yamazaki R, Ohtsuka H, Osaka I, Takuma K, Morita Y . Feasibility of laparoscopic surgery after stent insertion for obstructive colorectal cancer. Asian J Endosc Surg. 2017; 11(2):118-122. DOI: 10.1111/ases.12434. View

15.

Hashiguchi Y, Muro K, Saito Y, Ito Y, Ajioka Y, Hamaguchi T . Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol. 2019; 25(1):1-42. PMC: 6946738. DOI: 10.1007/s10147-019-01485-z. View

16.

Mayhew D, Mendonca V, Murthy B . A review of ASA physical status - historical perspectives and modern developments. Anaesthesia. 2019; 74(3):373-379. DOI: 10.1111/anae.14569. View

17.

Hanaoka M, Ogo T, Kawamura Y, Miura T, Aburatani T, Sugimoto H . Self-expandable Metal Stent as a Bridge to Surgery for Colorectal Cancer: Safety and Oncological Outcomes. In Vivo. 2020; 34(3):1325-1331. PMC: 7279850. DOI: 10.21873/invivo.11909. View

18.

Sato R, Oikawa M, Kakita T, Okada T, Abe T, Yazawa T . The prognostic value of the prognostic nutritional index and inflammation-based markers in obstructive colorectal cancer. Surg Today. 2020; 50(10):1272-1281. DOI: 10.1007/s00595-020-02007-5. View

19.

Sato R, Oikawa M, Kakita T, Okada T, Oyama A, Abe T . Comparison of the long-term outcomes of the self-expandable metallic stent and transanal decompression tube for obstructive colorectal cancer. Ann Gastroenterol Surg. 2019; 3(2):209-216. PMC: 6422834. DOI: 10.1002/ags3.12235. View

20.

Takahashi G, Yamada T, Iwai T, Takeda K, Koizumi M, Shinji S . Oncological Assessment of Stent Placement for Obstructive Colorectal Cancer from Circulating Cell-Free DNA and Circulating Tumor DNA Dynamics. Ann Surg Oncol. 2017; 25(3):737-744. DOI: 10.1245/s10434-017-6300-x. View