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KMID : 1188520110070020058
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Korean Journal of Clinical Oncology
2011 Volume.7 No. 2 p.58 ~ p.66
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Comparison of Long-term Outcome after Palliative Treatment for Unresctable Stage Ⅳ Colorectal Cancer Patients with Obstructive Symptoms: Self Expandable Metal Stents versus Surgery
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Yoo Hong-Yeol
Park Ji-Won
Kim Byung-Chang
Sohn Dae-Kyung
Hong Chang-Won
Park Sung-Chan
Choi Hyo-Seong
Oh Jae-Hwan
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Abstract
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Purpose: The aim of this study was to compare the long-term outcomes and the efficacy between palliative selfexpanding metal stent (SEMS) and palliative surgery in unresectable stage Ⅳ patients with obstructive symptoms.
Methods: Patients with symptomatic unresectable stage Ⅳ colorectal cancer who underwent insertion of SEMS (n = 88) or palliative surgery (n = 96) from January 2002 to May 2010 was included in the analysis. The success rates, complications, hospital day, time from treatment procedure to chemotherapy, and the overall survival were compared between the two groups. The independent factors related with overall survival were assessed.
Results: Early complication rate in the SEMS group was lower than in the surgery group (26.1% vs 47.9%, P = 0.002). However, the SEMS group had a higher late complication rate and major complication rate than the surgery group. (P ＜ 0.05). The percentage of bowel complications after procedure and additional procedures after complications in the SEMS group were higher than in the surgery group (P = 0.037). The overall survival in the surgery group was higher than in the SEMS group (median 15.7 months vs. 9.1 months), and more patients had to receive additional treatment due to complications in the SEMS group (P＜ 0.001).
Conclusion: SEMS therapy has been considered as relatively simple and less invasive treatment. However, it has more late complications and lower overall survival rates. Therefore, palliative treatment should be applied more carefully considering the site of tumor, symptoms and the status of the patient.
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KEYWORD
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unresectable, colorectal neoplasm, stents, palliative care
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