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

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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.

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Acknowledgements

We thank Kelly Zammit, BVSc, from Edanz (https://jp.edanz.com/ac) for editing this manuscript.

Funding

This study received no funding.

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Author notes

  1. Shintaro Kanaka and Akihisa Matsuda contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan

    Shintaro Kanaka, Akihisa Matsuda, Takeshi Yamada, Yasuyuki Yokoyama, Goro Takahashi, Hiromichi Sonoda, Kay Uehara, Seiichi Shinji, Takuma Iwai, Kohki Takeda, Sho Kuriyama, Toshimitsu Miyasaka & Hiroshi Yoshida

  2. Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, 1-383 Kosugi-Cho, Nakahara-Ku, Kawasaki, Kanagawa, 211-8533, Japan

    Yasuyuki Yokoyama, Ryo Ohta & Kumiko Sekiguchi

  3. Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Satoshi Matsumoto

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  1. Shintaro Kanaka
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Contributions

All authors agree with the content of the manuscript. Authors’ contributions are study concept and design; AM and TY, acquisition of data; YY, SM, GT, HS, RO, KU, SS, TI, KT, KS, SK, and TM; analysis and interpretation of data; KS, AM, and YT, drafting of the manuscript; KS and AM, study supervision; TY and HY.

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Correspondence to Akihisa Matsuda.

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Kanaka, S., Matsuda, A., Yamada, T. et al. Oncologic investigation of the interval from stent placement to surgery in patients with obstructive colorectal cancer. Surg Today (2024). https://doi.org/10.1007/s00595-024-02818-w

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