title: Comparison of treatment outcomes of endoscopic stenting for colonic and extracolonic malignant obstruction.
abstract: BACKGROUND
  Self-expandable metal stents (SEMS) have been used as a bridging or palliative treatment for malignant colorectal obstruction. Colonic obstruction also may arise from advanced extracolonic malignancy, but the clinical outcomes of stent placement for extracolonic malignancy are unclear. This study compared the clinical outcomes of SEMS between patients with colorectal cancer and those with extracolonic malignancy.
  
  
  METHODS
  Patients who underwent endoscopic SEMS placement for a malignant colorectal obstruction were enrolled at Seoul National University Hospital from April 2005 and August 2011. Their medical records were retrospectively reviewed in terms of success rate, complications, and duration of stent patency.
  
  
  RESULTS
  Endoscopic SEMS placements were performed for colorectal cancer in 149 patients and for extracolonic malignancy in 60 patients. The causes of obstruction in extracolonic malignancy were advanced gastric cancer in 39 patients (65%), pancreatic cancer in nine patients (15%), ovarian cancer in three patients (5%) and other causes in nine patients (15%). The clinical success rates were similar between the two groups (92.6 vs 86.7%; p = 0.688), and multivariate analysis showed no significant risk factor for unsuccessful endoscopic SEMS placement. Reobstruction in palliative endoscopic SEMS placement occurred for 16 patients with colorectal cancer (21.9%) and 18 patients with extracolonic malignancy (30%) during a median follow-up period of 90 days (p = 0.288). The rates did not differ significantly between the two groups (4.1 vs 8.3%; p = 0.467). The median duration of stent patency was 193 ± 42 days for the patients with colorectal cancer and 186 ± 31 days for the patients with extracolonic malignancy (p = 0.253). The duration of stent patency was not affected by underlying malignancy, previous surgery, or palliative chemotherapy.
  
  
  CONCLUSIONS
  Endoscopic SEMS placement is highly effective and comparable for palliation of obstruction in extracolonic malignancy and colorectal cancer in terms of clinical success, complications, and duration of patency.
authors: Division of Gastroenterology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine and Hospital, Seoul, Korea. carah79@naver.com
authors: Ji Yeon
authors: JY
authors: Kim
authors: Sang Gyun
authors: SG
authors: Kim
authors: Jong Pil
authors: JP
authors: Im
authors: Joo Sung
authors: JS
authors: Kim
authors: Hyun Chae
authors: HC
authors: Jung
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000209:etiology; D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D008297:Male; D010051:Ovarian Neoplasms / Q000150:complications; D010190:Pancreatic Neoplasms / Q000150:complications; D011351:Proctoscopy / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications; D016896:Treatment Outcome