Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study

Background/objectives: Colon cancer presents as an obstruction in almost 30% of patients. Self-expandable metallic stents emerged as an alternative to emergency surgery, despite early controversies around their use. Improved techniques led to stent incorporation in clinical guidelines. Our objective...

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Autores: Paniagua García-Señoráns, Marta, Cerdán Santacruz, Carlos, Cano Valderrama, Óscar, Aldrey Cao, Inés, Andrés-Asenjo, Beatriz, Pereira Pérez, Fernando, Flor Lorente, Blas, Biondo, Sebastiano
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/220044
Acceso en línea:https://hdl.handle.net/2445/220044
Access Level:acceso abierto
Palabra clave:Pròtesis de Stent
Càncer colorectal
Cirurgia oncològica
Stents (Surgery)
Colorectal cancer
Surgical oncology
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spelling Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective studyPaniagua García-Señoráns, MartaCerdán Santacruz, CarlosCano Valderrama, ÓscarAldrey Cao, InésAndrés-Asenjo, BeatrizPereira Pérez, FernandoFlor Lorente, BlasBiondo, SebastianoPròtesis de StentCàncer colorectalCirurgia oncològicaStents (Surgery)Colorectal cancerSurgical oncologyBackground/objectives: Colon cancer presents as an obstruction in almost 30% of patients. Self-expandable metallic stents emerged as an alternative to emergency surgery, despite early controversies around their use. Improved techniques led to stent incorporation in clinical guidelines. Our objective is to compare colectomies performed after the insertion of self-expandable metallic stents versus emergency surgeries in pT4 obstructive left colon cancer, analysing postoperative and oncological outcomes. Methods: This is an observational retrospective multicentre study involving 50 hospitals and analysing data from patients with pT4 obstructive tumours treated for curative intent between 2015 and 2017. Patients with left-sided obstructive colon cancer were included, with exclusion criteria being palliative surgery or incomplete resection. Primary outcomes were local, peritoneal, and systemic recurrence rates, overall survival (OS), and disease-free survival (DFS). Secondary outcomes were postoperative complications and the rate of surgeries without major complications. Results: In total, 196 patients were analysed, 128 undergoing emergency surgery and 68 receiving colonic stents. Stents more frequently allowed for minimally invasive surgeries: 33.8% vs. 4.7% (p < 0.01). The stent group showed fewer major complications (Clavien-Dindo ≥ 3) at 4.5% vs. 22.4% (p < 0.01), fewer infectious complications at 13.2% vs. 23.1% (p = 0.1), and fewer organ-space infections at 3.3% vs. 15.9% (p = 0.03). No significant differences in recurrence rates, 29.4% vs. 28.1% (p = 0.8); disease-free survival, 44.5 vs. 44.3 months (p = 0.5); or overall survival, 50.5 vs. 47.6 months (p = 0.4), were found between groups. Conclusions: Self-expandable metallic stents are a safe alternative for pT4 obstructive left colon cancer, improving postoperative outcomes without compromising short- and medium-term oncological results. Consideration of experienced clinicians and potential referral to centres with advanced stenting capabilities may enhance patient care.MDPI2025202520242025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion13 p.application/pdfapplication/pdfhttps://hdl.handle.net/2445/220044Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/cancers16234096Cancers, 2024, vol. 16, num.23https://doi.org/10.3390/cancers16234096cc-by (c) Paniagua García-Señoráns, M. et al., 2024http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2200442026-05-29T05:05:01Z
dc.title.none.fl_str_mv Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
title Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
spellingShingle Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
Paniagua García-Señoráns, Marta
Pròtesis de Stent
Càncer colorectal
Cirurgia oncològica
Stents (Surgery)
Colorectal cancer
Surgical oncology
title_short Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
title_full Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
title_fullStr Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
title_full_unstemmed Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
title_sort Beyond obstruction: evaluating self-expandable metallic stents (SEMSs) vs. emergency surgery for challenging pT4 obstructive colon cancer: multicentre retrospective study
dc.creator.none.fl_str_mv Paniagua García-Señoráns, Marta
Cerdán Santacruz, Carlos
Cano Valderrama, Óscar
Aldrey Cao, Inés
Andrés-Asenjo, Beatriz
Pereira Pérez, Fernando
Flor Lorente, Blas
Biondo, Sebastiano
author Paniagua García-Señoráns, Marta
author_facet Paniagua García-Señoráns, Marta
Cerdán Santacruz, Carlos
Cano Valderrama, Óscar
Aldrey Cao, Inés
Andrés-Asenjo, Beatriz
Pereira Pérez, Fernando
Flor Lorente, Blas
Biondo, Sebastiano
author_role author
author2 Cerdán Santacruz, Carlos
Cano Valderrama, Óscar
Aldrey Cao, Inés
Andrés-Asenjo, Beatriz
Pereira Pérez, Fernando
Flor Lorente, Blas
Biondo, Sebastiano
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Pròtesis de Stent
Càncer colorectal
Cirurgia oncològica
Stents (Surgery)
Colorectal cancer
Surgical oncology
topic Pròtesis de Stent
Càncer colorectal
Cirurgia oncològica
Stents (Surgery)
Colorectal cancer
Surgical oncology
description Background/objectives: Colon cancer presents as an obstruction in almost 30% of patients. Self-expandable metallic stents emerged as an alternative to emergency surgery, despite early controversies around their use. Improved techniques led to stent incorporation in clinical guidelines. Our objective is to compare colectomies performed after the insertion of self-expandable metallic stents versus emergency surgeries in pT4 obstructive left colon cancer, analysing postoperative and oncological outcomes. Methods: This is an observational retrospective multicentre study involving 50 hospitals and analysing data from patients with pT4 obstructive tumours treated for curative intent between 2015 and 2017. Patients with left-sided obstructive colon cancer were included, with exclusion criteria being palliative surgery or incomplete resection. Primary outcomes were local, peritoneal, and systemic recurrence rates, overall survival (OS), and disease-free survival (DFS). Secondary outcomes were postoperative complications and the rate of surgeries without major complications. Results: In total, 196 patients were analysed, 128 undergoing emergency surgery and 68 receiving colonic stents. Stents more frequently allowed for minimally invasive surgeries: 33.8% vs. 4.7% (p < 0.01). The stent group showed fewer major complications (Clavien-Dindo ≥ 3) at 4.5% vs. 22.4% (p < 0.01), fewer infectious complications at 13.2% vs. 23.1% (p = 0.1), and fewer organ-space infections at 3.3% vs. 15.9% (p = 0.03). No significant differences in recurrence rates, 29.4% vs. 28.1% (p = 0.8); disease-free survival, 44.5 vs. 44.3 months (p = 0.5); or overall survival, 50.5 vs. 47.6 months (p = 0.4), were found between groups. Conclusions: Self-expandable metallic stents are a safe alternative for pT4 obstructive left colon cancer, improving postoperative outcomes without compromising short- and medium-term oncological results. Consideration of experienced clinicians and potential referral to centres with advanced stenting capabilities may enhance patient care.
publishDate 2024
dc.date.none.fl_str_mv 2024
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/220044
url https://hdl.handle.net/2445/220044
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/cancers16234096
Cancers, 2024, vol. 16, num.23
https://doi.org/10.3390/cancers16234096
dc.rights.none.fl_str_mv cc-by (c) Paniagua García-Señoráns, M. et al., 2024
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Paniagua García-Señoráns, M. et al., 2024
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 13 p.
application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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