Skip to Main content Skip to Navigation
Journal articles

What is the Best Option Between Primary Diverting Stoma or Endoscopic Stent as a Bridge to Surgery with a Curative Intent for Obstructed Left Colon Cancer? Results from a Propensity Score Analysis of the French Surgical Association Multicenter Cohort of 518 Patients

Abstract : Background. Endoscopic stent (ES) as a bridge to surgery in obstructed left colon cancer (OLCC) is controversial. Our goal was to compare the operative and oncological results of primary diverting colostomy (PDC) and ES for the curative treatment of OLCC. Methods. Between 2000 and 2015, patients who underwent PDC or ES in a curative intent for OLCC at member centers of the French Surgical Association were included. Patients with unresectable tumors and/or synchronous metastases were excluded. Comparisons between the two groups were performed after ponderation with propensity score for: demographic and tumor characteristics, operative, and oncological results. Results. A total of 518 patients were included: PDC (n = 327); ES (n = 191). The demographic characteristics were similar between the groups. ES failed in 23% of the patients (11% perforation). Cumulative tumor resection rates were 80% and 86% after PDC and ES, respectively (p = 0.049). The rates of primary anastomosis were 57% in the PDC group and 40% in the ES group (p \0.0001). The permanent stoma rates were similar between the two groups (29% vs. 28%, p = 0.0586). Cumulative overall, surgical, and medical complications were significantly higher in PDC group. The resected tumors were significantly smaller and less frequently perforated and metastatic in the PDC group. The median overall survival was significantly higher after PDC (123.6 vs. 58.5 months, p = 0.046), whereas the median disease-free survival was similar between the two groups (54.1 vs. 53.6 months, p = 0.646). Conclusions. Although endoscopic stenting is associated with better surgical outcomes than diverting stoma, it may negatively impact histological features and overall survival.
Document type :
Journal articles
Complete list of metadatas

https://hal-normandie-univ.archives-ouvertes.fr/hal-02370425
Contributor : Sabine Douville <>
Submitted on : Tuesday, November 19, 2019 - 2:19:55 PM
Last modification on : Thursday, August 20, 2020 - 3:05:50 AM

Identifiers

Citation

Diane Mege, Charles Sabbagh, Gilles Manceau, Valérie Bridoux, Zaher Lakkis, et al.. What is the Best Option Between Primary Diverting Stoma or Endoscopic Stent as a Bridge to Surgery with a Curative Intent for Obstructed Left Colon Cancer? Results from a Propensity Score Analysis of the French Surgical Association Multicenter Cohort of 518 Patients. Annals of Surgical Oncology, Springer Verlag, 2019, 26 (3), pp.756-764. ⟨10.1245/s10434-018-07139-0⟩. ⟨hal-02370425⟩

Share

Metrics

Record views

58