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Published on: September 18, 2015
Clinicopathologic Features of Self-expandable-metallic Stent for Left-sided Obstructive Colorectal Cancer
Kimihiko Yoshida1, Satoru Kagami1, Kimihiko Funahashi1
1Department of General and Gastroenterological Surgery, Toho University School of Medicine, Tokyo, Japan.
Objectives:
We aimed to clarify the differences in clinical and histological characteristics between two decompression techniques for obstructive colorectal cancer (OCRC): trans-anal decompression tube (TADT) and self-expandable metallic stent (SEMS).
Methods:
Overall, 96 of 175 patients with OCRC treated in our department between 2000 and 2020, were assigned into TADT (n = 44) and SEMS (n = 52) groups, and the success rate and complications of decompression, surgical outcomes, clinicopathological findings, and prognosis were compared.
Results:
The technical success rate was high in all patients. During surgery, the SEMS group showed significant differences in laparoscopy (p < 0.01), D3 dissection (p < 0.001), and the number of lymph nodes dissected (p < 0.01). In multivariate analysis, lymphatic invasion was associated with decompression (odds ratio [OR], 5.49; 95% confidence interval [CI], 2.12-14.20; p < 0.01) and lymph node metastasis (OR, 4.44; 95% CI, 1.69-11.70; p < 0.01), while SEMS was associated with venous invasion (OR, 0.40; 95% CI, 0.16-0.98; p = 0.04). The 5-year and recurrence-free survival rates for 70 patients with stage II and III OCRC were 76.7% and 73.2%, respectively. Although there was no significant difference in the overall survival, the recurrence-free survival was significantly better in the SEMS group (85.0% vs. 58.3%, p = 0.04).
Conclusions:
The results of this study suggest that SEMS may be preferable to TADT from a histological perspective.
