Oncologic impact of colonic stents for obstructive left-sided colon cancer
作者机构：Department of Gastroenterological SurgeryTohoku Medical and Pharmaceutical UniversitySendai 983-8536MiyagiJapan
出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)
年 卷 期：2023年第14卷第1期
页 面：1-12页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Colonic stents Obstructive left-sided colon cancer Bridge to surgery Chemotherapy Long-term outcomes European Society of Gastrointestinal Endoscopy guidelines
摘 要：Colonic stenting has had a significant positive impact on the management of obstructive left-sided colon cancer(OLCC) in terms of both palliative treatment and bridge-to-surgery(BTS). Notably, many studies have convincingly demonstrated the effectiveness of stenting as a BTS, resulting in improvements in shortterm outcomes and quality of life, safety, and efficacy in subsequent curative surgery, and increased cost-effectiveness, whereas the safety of chemotherapy after stenting and the long-term outcomes of stenting as a BTS are controversial. Several studies have suggested an increased risk of perforation in patients receiving bevacizumab chemotherapy after colonic stenting. In addition, several pathological analyses have suggested a negative oncological impact of colonic stenting. In contrast, many recent studies have demonstrated that colonic stenting for OLCC does not negatively impact the safety of chemotherapy or long-term oncological outcomes. The updated version of the European Society of Gastrointestinal Endoscopy guidelines released in 2020 included colonic stenting as a BTS for OLCC as a recommended treatment. It should be noted that the experience of endoscopists is involved in determining technical and clinical success rates and possibly oncological outcomes. This review discusses the positive and negative impacts of colonic stenting on OLCC treatment, particularly in terms of oncology.
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