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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.
- Source :
-
International Journal of Colorectal Disease . Nov2019, Vol. 34 Issue 11, p1827-1838. 12p. 1 Diagram, 7 Charts, 3 Graphs. - Publication Year :
- 2019
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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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01791958
- Volume :
- 34
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- International Journal of Colorectal Disease
- Publication Type :
- Academic Journal
- Accession number :
- 139568595
- Full Text :
- https://doi.org/10.1007/s00384-019-03372-5