[Clinical Course of Advanced Colorectal Cancer Patients after Palliative Stoma Creation]

Some patients with advanced colorectal cancer present with bowel obstruction at diagnosis, requiring palliative stoma creation to relieve symptoms. However, the clinical course following this intervention remains poorly characterized, particularly in patients with limited tolerance for systemic therapy. We retrospectively analyzed 31 patients with metastatic colorectal cancer who underwent palliative stoma creation between 2018 and 2023. Patients were categorized into 3 groups:best supportive care(BSC, n=5), short-term chemotherapy(<3 months;ST-C, n=4), and long-term chemotherapy (≥3 months;LT-C, n=22). Significant differences in baseline performance status(PS), Glasgow prognostic score(GPS), and peritoneal dissemination were observed among the groups, with more favorable profiles in the LT-C group. Median overall survival was 2.4 months in the BSC group, 3.9 months in ST-C, and 27.2 months in LT-C. Curative resection was achieved in 4 LT-C patients. PS and GPS may help identify patients suitable for sustained chemotherapy. Given the comparable survival between the ST-C and BSC groups, the introduction of chemotherapy should be carefully considered in patients with poor baseline status.