Publication

Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction

Dutch Snapshot Res Grp, Amelung, F. J., Borstlap, W. A. A., Consten, E. C. J., Veld, J. V., van Halsema, E. E., Bemelman, W. A., Siersema, P. D., ter Borg, F., van Hooft, J. E. & Tanis, P. J., Jul-2019, In : British Journal of Surgery. 106, 8, p. 1075-1086 12 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Dutch Snapshot Res Grp, Amelung, F. J., Borstlap, W. A. A., Consten, E. C. J., Veld, J. V., van Halsema, E. E., ... Tanis, P. J. (2019). Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction. British Journal of Surgery, 106(8), 1075-1086. https://doi.org/10.1002/bjs.11172

Author

Dutch Snapshot Res Grp ; Amelung, F.J. ; Borstlap, Wernard A. A. ; Consten, E.C.J. ; Veld, J.V. ; van Halsema, E.E. ; Bemelman, Willem A. ; Siersema, Peter D. ; ter Borg, Frank ; van Hooft, Jeanin E. ; Tanis, Pieter J. / Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction. In: British Journal of Surgery. 2019 ; Vol. 106, No. 8. pp. 1075-1086.

Harvard

Dutch Snapshot Res Grp, Amelung, FJ, Borstlap, WAA, Consten, ECJ, Veld, JV, van Halsema, EE, Bemelman, WA, Siersema, PD, ter Borg, F, van Hooft, JE & Tanis, PJ 2019, 'Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction', British Journal of Surgery, vol. 106, no. 8, pp. 1075-1086. https://doi.org/10.1002/bjs.11172

Standard

Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction. / Dutch Snapshot Res Grp; Amelung, F.J.; Borstlap, Wernard A. A.; Consten, E.C.J.; Veld, J.V. ; van Halsema, E.E.; Bemelman, Willem A.; Siersema, Peter D.; ter Borg, Frank; van Hooft, Jeanin E.; Tanis, Pieter J.

In: British Journal of Surgery, Vol. 106, No. 8, 07.2019, p. 1075-1086.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Dutch Snapshot Res Grp, Amelung FJ, Borstlap WAA, Consten ECJ, Veld JV, van Halsema EE et al. Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction. British Journal of Surgery. 2019 Jul;106(8):1075-1086. https://doi.org/10.1002/bjs.11172


BibTeX

@article{926c4d7b2381453d88544932f2c4a564,
title = "Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction",
abstract = "Background: Although self-expandable metal stent (SEMS) placement as bridge to surgery (BTS) in patients with left-sided obstructing colonic cancer has shown promising short-term results, it is used infrequently owing to uncertainty about its oncological safety. This population study compared long-term oncological outcomes between emergency resection and SEMS placement as BTS.Methods: Through a national collaborative research project, long-term outcome data were collected for all patients who underwent resection for left-sided obstructing colonic cancer between 2009 and 2016 in 75 Dutch hospitals. Patients were identified from the Dutch Colorectal Audit database. SEMS as BTS was compared with emergency resection in the curative setting after 1: 2 propensity score matching.Results: Some 222 patients who had a stent placed were matched to 444 who underwent emergency resection. The overall SEMS-related perforation rate was 7.7 per cent (17 of 222). Three-year locoregional recurrence rates after SEMS insertion and emergency resection were 11-4 and 13.6 per cent (P= 0-457), disease-free survival rates were 58-8 and 52.6 per cent (P= 0-175), and overall survival rates were 74-0 and 68-3 per cent (P= 0.231), respectively. SEMS placement resulted in significantly fewer permanent stomas (23.9 versus 45.3 per cent; P <0-001), especially in elderly patients (29.0 versus 57.9 per cent; P <0-001). For patients in the SEMS group with or without perforation, 3-year locoregional recurrence rates were 18 and 11.0 per cent (P= 0.432), disease-free survival rates were 49 and 59.6 per cent (P= 0-717), and overall survival rates 61 and 75.1 per cent (P= 0.529), respectively.Conclusion: Overall, SEMS as BTS seems an oncologically safe alternative to emergency resection with fewer permanent stomas. Nevertheless, the risk of SEMS-related perforation, as well as permanent stoma, might influence shared decision-making for individual patients.",
keywords = "LARGE-BOWEL OBSTRUCTION, TUMOR-CELL DISSEMINATION, EXPANDABLE METAL STENTS, LONG-TERM OUTCOMES, CANCER, MANAGEMENT, IMPACT, INSERTION, TRIAL",
author = "{Dutch Snapshot Res Grp} and Furnee, {E. J. B.} and K. Havenga and F.J. Amelung and Borstlap, {Wernard A. A.} and E.C.J. Consten and J.V. Veld and {van Halsema}, E.E. and Bemelman, {Willem A.} and Siersema, {Peter D.} and {ter Borg}, Frank and {van Hooft}, {Jeanin E.} and Tanis, {Pieter J.}",
year = "2019",
month = "7",
doi = "10.1002/bjs.11172",
language = "English",
volume = "106",
pages = "1075--1086",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "Wiley",
number = "8",

}

RIS

TY - JOUR

T1 - Propensity score-matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left-sided colonic obstruction

AU - Dutch Snapshot Res Grp

AU - Furnee, E. J. B.

AU - Havenga, K.

AU - Amelung, F.J.

AU - Borstlap, Wernard A. A.

AU - Consten, E.C.J.

AU - Veld, J.V.

AU - van Halsema, E.E.

AU - Bemelman, Willem A.

AU - Siersema, Peter D.

AU - ter Borg, Frank

AU - van Hooft, Jeanin E.

AU - Tanis, Pieter J.

PY - 2019/7

Y1 - 2019/7

N2 - Background: Although self-expandable metal stent (SEMS) placement as bridge to surgery (BTS) in patients with left-sided obstructing colonic cancer has shown promising short-term results, it is used infrequently owing to uncertainty about its oncological safety. This population study compared long-term oncological outcomes between emergency resection and SEMS placement as BTS.Methods: Through a national collaborative research project, long-term outcome data were collected for all patients who underwent resection for left-sided obstructing colonic cancer between 2009 and 2016 in 75 Dutch hospitals. Patients were identified from the Dutch Colorectal Audit database. SEMS as BTS was compared with emergency resection in the curative setting after 1: 2 propensity score matching.Results: Some 222 patients who had a stent placed were matched to 444 who underwent emergency resection. The overall SEMS-related perforation rate was 7.7 per cent (17 of 222). Three-year locoregional recurrence rates after SEMS insertion and emergency resection were 11-4 and 13.6 per cent (P= 0-457), disease-free survival rates were 58-8 and 52.6 per cent (P= 0-175), and overall survival rates were 74-0 and 68-3 per cent (P= 0.231), respectively. SEMS placement resulted in significantly fewer permanent stomas (23.9 versus 45.3 per cent; P <0-001), especially in elderly patients (29.0 versus 57.9 per cent; P <0-001). For patients in the SEMS group with or without perforation, 3-year locoregional recurrence rates were 18 and 11.0 per cent (P= 0.432), disease-free survival rates were 49 and 59.6 per cent (P= 0-717), and overall survival rates 61 and 75.1 per cent (P= 0.529), respectively.Conclusion: Overall, SEMS as BTS seems an oncologically safe alternative to emergency resection with fewer permanent stomas. Nevertheless, the risk of SEMS-related perforation, as well as permanent stoma, might influence shared decision-making for individual patients.

AB - Background: Although self-expandable metal stent (SEMS) placement as bridge to surgery (BTS) in patients with left-sided obstructing colonic cancer has shown promising short-term results, it is used infrequently owing to uncertainty about its oncological safety. This population study compared long-term oncological outcomes between emergency resection and SEMS placement as BTS.Methods: Through a national collaborative research project, long-term outcome data were collected for all patients who underwent resection for left-sided obstructing colonic cancer between 2009 and 2016 in 75 Dutch hospitals. Patients were identified from the Dutch Colorectal Audit database. SEMS as BTS was compared with emergency resection in the curative setting after 1: 2 propensity score matching.Results: Some 222 patients who had a stent placed were matched to 444 who underwent emergency resection. The overall SEMS-related perforation rate was 7.7 per cent (17 of 222). Three-year locoregional recurrence rates after SEMS insertion and emergency resection were 11-4 and 13.6 per cent (P= 0-457), disease-free survival rates were 58-8 and 52.6 per cent (P= 0-175), and overall survival rates were 74-0 and 68-3 per cent (P= 0.231), respectively. SEMS placement resulted in significantly fewer permanent stomas (23.9 versus 45.3 per cent; P <0-001), especially in elderly patients (29.0 versus 57.9 per cent; P <0-001). For patients in the SEMS group with or without perforation, 3-year locoregional recurrence rates were 18 and 11.0 per cent (P= 0.432), disease-free survival rates were 49 and 59.6 per cent (P= 0-717), and overall survival rates 61 and 75.1 per cent (P= 0.529), respectively.Conclusion: Overall, SEMS as BTS seems an oncologically safe alternative to emergency resection with fewer permanent stomas. Nevertheless, the risk of SEMS-related perforation, as well as permanent stoma, might influence shared decision-making for individual patients.

KW - LARGE-BOWEL OBSTRUCTION

KW - TUMOR-CELL DISSEMINATION

KW - EXPANDABLE METAL STENTS

KW - LONG-TERM OUTCOMES

KW - CANCER

KW - MANAGEMENT

KW - IMPACT

KW - INSERTION

KW - TRIAL

U2 - 10.1002/bjs.11172

DO - 10.1002/bjs.11172

M3 - Article

VL - 106

SP - 1075

EP - 1086

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 8

ER -

ID: 93756972