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

Shintaro Kanaka; Akihisa Matsuda; Takeshi Yamada; Yasuyuki Yokoyama; Satoshi Matsumoto; Goro Takahashi; Hiromichi Sonoda; Ryo Ohta; Kay Uehara; Seiichi Shinji; Takuma Iwai; Kohki Takeda; Kumiko Sekiguchi; Sho Kuriyama; Toshimitsu Miyasaka; Hiroshi Yoshida

doi:10.1007/s00595-024-02818-w

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

Surg Today. 2024 Mar 25. doi: 10.1007/s00595-024-02818-w. Online ahead of print.

Authors

Shintaro Kanaka^#¹, Akihisa Matsuda^#², Takeshi Yamada¹, Yasuyuki Yokoyama^{1

3}, Satoshi Matsumoto⁴, Goro Takahashi¹, Hiromichi Sonoda¹, Ryo Ohta³, Kay Uehara¹, Seiichi Shinji¹, Takuma Iwai¹, Kohki Takeda¹, Kumiko Sekiguchi³, Sho Kuriyama¹, Toshimitsu Miyasaka¹, Hiroshi Yoshida¹

Affiliations

¹ Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
² Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan. a-matsu@nms.ac.jp.
³ Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-383 Kosugi-Cho, Nakahara-Ku, Kawasaki, Kanagawa, 211-8533, Japan.
⁴ Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan.

^# Contributed equally.

PMID: 38526561
DOI: 10.1007/s00595-024-02818-w

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.