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Does preoperative stent positioning in obstructive left sided colon cancer increase the risk of perineural invasion?

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Abstract

Colonic stenting as a bridge to surgery has been shown to be a safe and effective treatment for left-sided malignant colonic obstruction depending on local expertise. However, concerns still exist regarding its oncological safety. In particular, several reports showed an increased prevalence of perineural tumor invasion following stent placement. Since perineural invasion negatively affects oncological outcomes, the present study sought to evaluate this controversial association. We retrospectively reviewed 114 patients presenting with left-side obstructing colon cancer over a 10-year period. The relationship between perineural invasion and colonic stenting was analyzed using univariate and multivariate analyses. Perineural invasion was found to be strongly associated with pathological features, including TNM stage, (p < 0.001), poor differentiation (p = 0.002), vascular invasion (p < 0.001), lymphatic invasion (p < 0.001), whereas no significant association with preoperative stenting was observed (p = 0.918) after performing univariate analysis. In the multivariate model, only TNM stage III–IV (OR: 6.810, 95% CI 1.972–23.518, p = 0.002) and venous invasion (OR: 5.325, 95% CI 1.911–14.840, p = 0.001) were independently associated with perineural invasion. The results of this study suggest no association between preoperative colonic stenting and perineural invasion.

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Authors and Affiliations

  1. Department of Surgery, ASST Monza, Ospedale San Gerardo Hospital, Via Pergolesi 33, Monza, Italy

    Nicolò Tamini, Luca Nespoli, Massimo Oldani, Marco Braga & Luca Gianotti

  2. School of Medicine and Surgery, University Milano-Bicocca, Monza, Italy

    Marco Angrisani, Simone Aldè, Luca Nespoli, Marco Braga & Luca Gianotti

Authors
  1. Nicolò Tamini
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  2. Marco Angrisani
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  3. Simone Aldè
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  4. Luca Nespoli
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  5. Massimo Oldani
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  6. Marco Braga
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  7. Luca Gianotti
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Contributions

Conception and design: NT, MA, SA, LG. Analysis and interpretation of the data: NT, MA, SA,LN, MO, MB, LG. Drafting of the article: NT, MA, LN, LG. Critical revision of the article for important intellectual content: NT, MA, SA, LN, MO, MB, LG. Final approval of the article: NT, MA, SA,LN, MO, MB, LG.

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Correspondence to Nicolò Tamini.

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The authors declare that they have no conflicts of interest and no funding sources have been received.

Ethical approval

The study protocol followed the ethical guidelines of the 1975 Declaration of Helsinki (as revised in Brazil 2013). The local Ethical Committee review of the protocol deemed that formal approval was not required owing to the retrospective, observational, and anonymous nature of this study.

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Tamini, N., Angrisani, M., Aldè, S. et al. Does preoperative stent positioning in obstructive left sided colon cancer increase the risk of perineural invasion?. Updates Surg 73, 547–553 (2021). https://doi.org/10.1007/s13304-020-00962-9

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  • DOI: https://doi.org/10.1007/s13304-020-00962-9

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