The long-term recurrence rate and survival of obstructive left-sided colon cancer patients: a stent as a bridge to surgery

Rev Esp Enferm Dig. 2018 Nov;110(11):718-725. doi: 10.17235/reed.2018.5077/2017.

Abstract

Background: a colonic stent as a bridge to elective surgery for left-sided malignant colonic obstruction is an alternative to the classical treatment. The aim of our study was to evaluate the recurrence rate as well as the morbidity and mortality of this treatment.

Patients and methods: patients admitted to the Emergency Department with left-sided malignant colonic obstruction between June 2006 and January 2014 were analyzed in a retrospective observational study. Patients who underwent self-expanding metallic stent placement via endoscopy as a bridge to surgery were included. The observation period was performed until May 2017.

Results: fifty-three patients were treated with a colonic stent as a bridge to surgery; nine patients died during the postoperative period. The deceased patients were more frequently male (100% in the deceased vs 62% in the non-deceased, p = 0.02), with a more advanced age (81.4 ± 5.1 vs 71.6 ± 10.8, p < 0.001), lower hemoglobin levels on admission (12.9 vs 13.6 p < 0.001), a greater number of leukocytes (12,918 vs 9,437, p < 0.001) and greater coagulopathy (INR 1.6 vs 1, p < 0.001). Eight patients had a distant relapse with a median disease-free survival of 19.1 months. The variables were compared according to the appearance of distant disease and the mean age was lower in patients with a recurrence (65.9 ± 11.3 vs 74.9 ± 9.9, p < 0.001).

Conclusions: the results of the use of a stent as a bridge to curative surgery in patients with obstructive left colon cancer in our hospital is comparable to previous studies.

Publication types

  • Observational Study

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / pathology
  • Aged
  • Aged, 80 and over
  • Colonic Diseases / etiology*
  • Colonic Diseases / surgery*
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / epidemiology*
  • Colonic Neoplasms / pathology
  • Female
  • Humans
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery*
  • Longitudinal Studies
  • Male
  • Neoplasm Recurrence, Local / epidemiology*
  • Retrospective Studies
  • Stents*
  • Survival Rate
  • Time Factors