Oncologic investigation of the interval from stent placement to surgery in patients with obstructive colorectal cancer

Surg Today. 2024 Sep;54(9):1093-1103. doi: 10.1007/s00595-024-02818-w. Epub 2024 Mar 25.

Abstract

Purpose: Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking.

Methods: We retrospectively collected data from patients with BTS between January 2013 and October 2021. Inverse probability treatment-weighted propensity score analyses were used to compare short- and long-term outcomes between the short-interval (SI) and long-interval (LI) groups, using a cutoff of 20 days.

Results: In total, 138 patients were enrolled in this study (SI group, n = 63; LI group, n = 75). In the matched cohort, the patients' backgrounds were well balanced. The incidence of Clavien-Dindo grade ≥ II postoperative complications was not significantly different between the SI and LI groups (19.0% vs. 14.0%, P = 0.47). There were no significant differences between the SI and LI groups in the 3-year recurrence-free survival (68.0% vs. 76.4%, P = 0.73) or 3-year overall survival rates (86.0% vs. 90.6%, P = 0.72).

Conclusions: A longer interval did not deteriorate the oncological outcomes. Individual perioperative management with an appropriate interval to improve the patient's condition is required to ensure safe surgery.

Keywords: Colorectal cancer; Interval; Stent; Surgery; Survival.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms* / complications
  • Colorectal Neoplasms* / surgery
  • Elective Surgical Procedures / methods
  • Female
  • Humans
  • Intestinal Obstruction* / etiology
  • Intestinal Obstruction* / surgery
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Propensity Score
  • Retrospective Studies
  • Self Expandable Metallic Stents
  • Stents
  • Survival Rate
  • Time Factors
  • Time-to-Treatment
  • Treatment Outcome