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Impact of peritoneal carcinomatosis on clinical outcomes of patients receiving self-expandable metal stents for malignant colorectal obstruction

Authors
 Jae Jun Park  ;  Kwangwon Rhee  ;  Jin Young Yoon  ;  Soo Jung Park  ;  Joo Hee Kim  ;  Jie-Hyun Kim  ;  Young Hoon Youn  ;  Tae Il Kim  ;  Hyojin Park  ;  Won Ho Kim  ;  Jae Hee Cheon 
Citation
 Endoscopy, Vol.50(12) : 1163-1174, 2018 
Journal Title
 Endoscopy 
ISSN
 0013-726X 
Issue Date
2018
Abstract
BACKGROUND:  Peritoneal carcinomatosis can influence clinical outcomes of patients receiving self-expandable metal stents (SEMS) for malignant colorectal obstruction, but data regarding this issue are sparse. We analyzed the clinical outcomes of post-SEMS insertion for malignant colorectal obstruction based on carcinomatosis status. METHODS:  Stent- and patient-related clinical outcomes were compared for carcinomatosis status in a retrospective review involving 323 consecutive patients (colorectal cancer 198 patients; extracolonic malignancy 125 patients) who underwent palliative SEMS placement for malignant colorectal obstruction from January 2005 to March 2012. Severity of carcinomatosis was classified as mild, moderate, or severe. RESULTS:  Carcinomatosis was observed in 190 patients (58.8 %). The rates of technical (84.7 vs. 94.7 %; P = 0.005) and clinical (73.2 vs. 83.5 %; P = 0.03) success were lower in patients with vs. without carcinomatosis. Rates of early (2.1 % vs. 3.0 %; P = 0.72) and delayed (1.6 % vs. 6.0 %; P = 0.08) perforation and stent failure (27.9 % vs. 26.3 %; P = 0.75) showed no difference. Technical and clinical success rates were significantly different based on the severity of carcinomatosis (technical success rate: mild 90.7 %, moderate 97.4 %, severe 76.3 %, P = 0.003; clinical success rate: mild 83.3 %, moderate 82.1 %, severe 63.9 %, P = 0.01). In multivariate analysis, severe carcinomatosis was identified as an independent factor related to technical (odds ratio [OR] 0.18, 95 % confidence interval [CI] 0.06 - 0.56) and clinical (OR 0.33, 95 %CI 0.15 - 0.74) success. CONCLUSIONS:  Peritoneal carcinomatosis was associated with decreased technical and clinical success rates in patients receiving SEMS for malignant colorectal obstruction. Moreover, the presence of severe carcinomatosis was an independent factor determining these clinical outcomes.
Full Text
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-0657-3764
DOI
10.1055/a-0657-3764
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김원호(Kim, Won Ho) ORCID logo https://orcid.org/0000-0002-5682-9972
김주희(Kim, Joo Hee) ORCID logo https://orcid.org/0000-0001-5383-3602
김지현(Kim, Jie-Hyun) ORCID logo https://orcid.org/0000-0002-9198-3326
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
박수정(Park, Soo Jung)
박재준(Park, Jae Jun)
박효진(Park, Hyo Jin) ORCID logo https://orcid.org/0000-0003-4814-8330
윤영훈(Youn, Young Hoon) ORCID logo https://orcid.org/0000-0002-0071-229X
이광원(Rhee, Kwang Won)
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166870
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