title: Palliative self-expandable metal stents for acute malignant colorectal obstruction: clinical outcomes and risk factors for complications.
abstract: OBJECTIVE
  Self-expandable metal stents (SEMSs) have been used as palliative treatment or bridge to surgery for obstructions caused by colorectal cancer (CRC). We assessed the long-term outcomes of palliative SEMSs and evaluated the risk factors influencing complications.
  
  
  METHODS
  One hundred and seventy-five patients underwent SEMS placement for acute malignant colorectal obstruction. Of the 72 patients who underwent palliative treatment for primary CRC, 30 patients received chemotherapy (CT) for primary cancer (CT group) and 42 underwent best supportive treatment (BST) without CT (BST group).
  
  
  RESULTS
  There was a significant difference in late migration between the CT group and the BST group (20.0% in CT group, 2.4% in BST group, p = 0.018). Response to CT influenced the rate of late obstruction (0% in disease control, 35.7% in disease progression, p = 0.014). However, late obstruction was not associated with stent properties, such as diameter or type (≤22 mm vs. >22 mm, 13.5% vs. 14.3%, p = 1.00; uncovered stent vs. covered stent, 15.5% vs. 7.1%, p = 0.675) and migration (≤22 mm vs. >22 mm, 16.2% vs. 2.9%, p = 0.108; uncovered stent vs. covered stent, 8.6% vs. 14.3%, p = 0.615) in palliative SEMS.
  
  
  CONCLUSIONS
  The administration of CT increases the rate of stent migration, and disease control by CT can reduce the risk of obstruction by maintaining the luminal patency of palliative SEMSs.
authors.affiliation: Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine , Bucheon , Korea.
authors.forename: Jae Pil
authors.initials: JP
authors.lastname: Han
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Shin Hee
authors.initials: SH
authors.lastname: Kim
authors.forename: Jong Hyo
authors.initials: JH
authors.lastname: Choi
authors.forename: Hee Jae
authors.initials: HJ
authors.lastname: Jung
authors.forename: Youn Hee
authors.initials: YH
authors.lastname: Cho
authors.forename: Bong Min
authors.initials: BM
authors.lastname: Ko
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008670:Metals; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D008670:Metals
keywords: chemotherapy; colorectal cancer; self-expandable metal stent