Palliative stent for malignant colonic obstruction by extracolonic malignancy: a comparison with colorectal cancer.
OBJECTIVE
Palliative self-expandable metal stent placement for colonic obstruction arising from an extracolonic malignancy might be as useful as that for colorectal cancer, but data are limited. The purposes of this study were to investigate success and complications of stent placement in patients with extracolonic malignancy and to compare long-term clinical outcomes for an extracolonic malignancy group with those for a colorectal cancer group.


METHODS
We reviewed short-term and long-term outcomes for patients treated with palliative stents for colonic obstruction by extracolonic malignancy (n = 44) or unresectable colorectal cancer (n = 53) from January 2006 to March 2011.


RESULTS
Neither the technical success (93.2 vs. 98.1 %, respectively; P = 0.326) nor clinical success (77.3 vs. 84.9 %, respectively; P = 0.433) of stent placement differed significantly in the two groups. Complications as a result of stent placement also differed only slightly in the two groups (perforation: 4.8 % (two cases) vs. 0 %, respectively; migration: 4.8 vs. 5.8 %, respectively, P = 0.343). With regard to long-term outcomes, although stent patency was shorter in the extracolonic malignancy group (P = 0.015), because overall survival in this group was also shorter (P = 0.018), it was sufficient for palliative purposes.


CONCLUSIONS
Palliative stent placement was equally effective and safe for treatment of colonic obstruction arising from either extracolonic malignancy or unresectable colorectal cancer. Even in cases of colonic obstruction arising from extracolonic malignancy, stent placement should be considered as primary palliative therapy.
Sung Jin
SJ
Moon
Sang Woo
SW
Kim
Bo-In
BI
Lee
Chul-Hyun
CH
Lim
Jin Soo
JS
Kim
Jin
J
Soo
Jae Myung
JM
Park
In Seok
IS
Lee
Myung-Gyu
MG
Choi
Kyu Yong
KY
Choi
D000008:Abdominal Neoplasms / Q000150:complications*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications*; D015179:Colorectal Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome