Oncologic investigation of the interval from stent placement to surgery in patients with obstructive colorectal cancer

• Published in: Surgery today (Tokyo, Japan) Japan), 2024-09, Vol.54 (9), p.1093-1103
• Main Authors: Kanaka, Shintaro, Matsuda, Akihisa, Yamada, Takeshi, Yokoyama, Yasuyuki, Matsumoto, Satoshi, Takahashi, Goro, Sonoda, Hiromichi, Ohta, Ryo, Uehara, Kay, Shinji, Seiichi, Iwai, Takuma, Takeda, Kohki, Sekiguchi, Kumiko, Kuriyama, Sho, Miyasaka, Toshimitsu, Yoshida, Hiroshi
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Colorectal Neoplasms - complications; Colorectal Neoplasms - surgery; Elective Surgical Procedures - methods; Female; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Propensity Score; Retrospective Studies; Self Expandable Metallic Stents; Stents; Surgery; Surgical Oncology; Survival Rate; Time Factors; Time-to-Treatment; Treatment Outcome
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02818-w

Purpose Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking. Methods We retrospectively collected data from patients with BTS between January 2013 and October 2021. Inverse probability treatment-weighted propensity score analyses were used to compare short- and long-term outcomes between the short-interval (SI) and long-interval (LI) groups, using a cutoff of 20 days. Results In total, 138 patients were enrolled in this study (SI group, n  = 63; LI group, n  = 75). In the matched cohort, the patients’ backgrounds were well balanced. The incidence of Clavien–Dindo grade ≥ II postoperative complications was not significantly different between the SI and LI groups (19.0% vs. 14.0%, P  = 0.47). There were no significant differences between the SI and LI groups in the 3-year recurrence-free survival (68.0% vs . 76.4%, P  = 0.73) or 3-year overall survival rates (86.0% vs . 90.6%, P  = 0.72). Conclusions A longer interval did not deteriorate the oncological outcomes. Individual perioperative management with an appropriate interval to improve the patient’s condition is required to ensure safe surgery.