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International Journal of Colorectal Disease

, Volume 34, Issue 7, pp 1241–1250 | Cite as

Better recurrence-free survival after stent bridge to surgery compared to emergency surgery for obstructive left-sided colonic cancer in patients with stage III status of the American Joint Committee on Cancer (AJCC): a bicentric retrospective study

  • Carmen Lara-RomeroEmail author
  • Ángel Vilches
  • Ángel Caunedo-Álvarez
  • Pedro Hergueta-Delgado
  • Isabel Lavín-Castejón
  • Raúl Andrade-Bellido
  • Guillermo Alcaín-Martínez
Original Article
  • 70 Downloads

Abstract

Purpose

Stenting as a bridge to surgery (SBTS) can transform an emergency surgery (ES) into an elective surgery in patients with symptomatic left-sided malignant colonic obstruction. Concerns have been raised regarding short-term morbidity and long-term oncologic outcomes, with contrasting results reported in the literature. Our main aim is to evaluate not only long-term oncologic outcomes but also short-term postoperative outcomes of stented patients who underwent elective surgery compared to those who had ES.

Methods

From January 2006 to May 2012, we retrospectively identified patients with confirmed left-sided colorectal cancer obstruction. This was done in two centers of reference of colorectal diseases in southern Spain with patients who were treated with curative intent either with ES or SBTS. The short- and long-term results were compared between both groups.

Results

There were 71 patients in the stenting group and 66 in the emergency surgery group, with similar demographic data. Initial stoma creation rates were lower in the SBTS group (16.9% vs. 54.5%, p < 0.005) and the primary anastomosis rate was higher in the same group (83.1% vs. 45.5%, p < 0.005). Five-year recurrence-free survival (RFS) rates were comparable between groups (75.3 vs. 59.8%, p = 0.220), but RFS rates at 5 years for AJCC pathologic stage III were higher in the stenting group (69.7% vs 30%, p = 0.004). Both groups were comparable regarding overall and cancer-specific survival outcomes.

Conclusions

The use of SBTS reduces ostomy rates in patients with obstructive colon malignancies. Long-term survival results are similar. Patients in the SBTS group with stage III AJCC status showed a higher 5-year recurrence-free survival rate than those in the ES group.

Keywords

Colonic stenting Bridge to surgery Malignant left-sided colonic obstruction 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Carmen Lara-Romero
    • 1
    • 2
    Email author
  • Ángel Vilches
    • 3
  • Ángel Caunedo-Álvarez
    • 2
  • Pedro Hergueta-Delgado
    • 2
  • Isabel Lavín-Castejón
    • 1
  • Raúl Andrade-Bellido
    • 1
  • Guillermo Alcaín-Martínez
    • 1
  1. 1.Department of Digestive DiseasesVirgen de la Victoria University HospitalMálagaSpain
  2. 2.Department of Digestive DiseasesVirgen Macarena University HospitalSevilleSpain
  3. 3.Department of Epidemiology and StatisticsSeville UniversitySevilleSpain

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