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12.09.2019 | Review Open Access

Long-term tumour outcomes of self-expanding metal stents as ‘bridge to surgery’ for the treatment of colorectal cancer with malignant obstruction: a systematic review and meta-analysis

Zeitschrift:
International Journal of Colorectal Disease
Autoren:
Yinghao Cao, Junnan Gu, Shenghe Deng, Jiang Li, Ke Wu, Kailin Cai
Wichtige Hinweise
Yinghao Cao, Junnan Gu and Shenghe Deng contributed equally to this work and they were considered co-first authors.

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

To explore the long-term oncological results of self-expanding metal stents (SEMS) as a surgical transition compared with those of simple emergency surgery.

Methods

A systematic review of studies involving long-term tumour outcomes comparing SEMS with emergency surgery was conducted. All studies included information on 3-year and 5-year survival rates, 3-year and 5-year disease-free survival (DFS) rates, and local and overall recurrence rates; the results were expressed as odds ratios.

Results

Overall, 24 articles and 2508 patients were included, including 5 randomised controlled trials, 3 prospective studies, and 16 retrospective studies. The 3-year survival rate (odds ratio (OR) = 0.88, 95% confidence interval (CI) 0.69–1.12, P = 0.05), 5-year survival rate (OR = 0.91, 95% CI 0.70–1.17, P = 0.67), 3-year DFS rate (OR = 1.14, 95% CI 0.91–1.42, P = 0.65), 5-year DFS rate (OR = 1.35, 95% CI 0.91–2.02, P = 0.17), overall recurrence rate (OR 1.04, 95% CI 0.77–1.41, P = 0.14), and local recurrence rate (OR 1.37, 95% CI 0.84–2.23, P = 0.92) were determined. There was no significant difference between the randomised and observational studies in the subgroup analysis, and the 5-year survival rate was higher in studies with a stent placement success rate of ≥ 95%.

Conclusion

SEMS implantation was a viable alternative in malignant left colon obstruction as a transition to surgery; its long-term survival results, including 5-year DFS and overall survival, were equivalent to those of emergent surgery.

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