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Oncologic outcomes of self-expanding metallic stent insertion as a bridge to surgery in the management of left-sided colon cancer obstruction: comparison with nonobstructing elective surgery
World Journal of Surgery, 04/15/09

Kim JS et al. - In a study to compare the outcomes of bridge to surgery after self-expanding metallic stents (SEMS) insertion and nonobstructing elective surgery, data show that insertion of SEMS as a bridge to surgery in management of left-sided colon cancer obstruction is possibly associated with adverse oncologic outcomes compared with nonobstructing elective surgery, but it is unclear what magnitude of this effect is related to underlying obstruction rather than to the SEMS.

• 35 pts who had left-sided colon malignancy obstruction and underwent surgical resection after SEMS insertion (group A) were matched to 350 pts who underwent elective surgery for nonobstructing left-sided colon cancer based on stage II, III, and IV malignancies according to the 2001 American Joint Committee on Cancer (group B).
• Group B was randomly extracted from the colorectal database.
• The 2 groups were compared for clinicopathologic variables, complications, and survival rate.

• There were no significant differences in clinicopathologic variables between group A and group B.
• Stoma formation rate was statistically different between the 2 groups.
• SEMS insertion had an adverse effect on 5-yr overall survival rate (A vs B, 38.4% vs 65.6%, respectively) and 5-yr disease-free survival rate (A vs B, 48.3% vs 75.5%, respectively).

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