Chok AY, Zhao Y, Lim HJ, Ng YYR, Tan EJKW. Stenting as a bridge to surgery in obstructing colon cancer: Long-term recurrence pattern and competing risk of mortality. World J Gastrointest Endosc 2023; 15(2): 64-76 [PMID: 36925648 DOI: 10.4253/wjge.v15.i2.64]
Corresponding Author of This Article
Aik Yong Chok, FRCS (Ed), MBBS, MMed, Surgeon, Department of Colorectal Surgery, Singapore General Hospital, 20 College Road, Singapore 169608, Singapore. chokaikyong@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Feb 16, 2023; 15(2): 64-76 Published online Feb 16, 2023. doi: 10.4253/wjge.v15.i2.64
Stenting as a bridge to surgery in obstructing colon cancer: Long-term recurrence pattern and competing risk of mortality
Aik Yong Chok, Yun Zhao, Hui Jun Lim, Yvonne Ying Ru Ng, Emile John Kwong Wei Tan
Aik Yong Chok, Yun Zhao, Hui Jun Lim, Yvonne Ying Ru Ng, Emile John Kwong Wei Tan, Department of Colorectal Surgery, Singapore General Hospital, Singapore 169608, Singapore
Yun Zhao, Department of Group Analytics, Singapore Health Services, Singapore 168582, Singapore
Author contributions: Chok AY and Tan EJKW designed the study and interpreted the data; Zhao Y performed the analysis and visualisation; Lim HJ and Ng YYR performed the literature review and clinical data collection; Chok AY, Zhao Y and Lim HJ drafted the manuscript; Chok AY, Zhao Y and Ng YYR edited the manuscript; Chok AY and Tan EJKW provided critical revision for final approval; all authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by Singapore Health Services (SingHealth) Institutional Review Board (IRB Ref. 2017/2481). All methods were carried out in accordance with relevant guidelines and regulations (Declaration of Helsinki).
Informed consent statement: Due to the study’s retrospective design using de-identified data, written informed consent collection was waived by SingHealth Centralised Institutional Review Board.
Conflict-of-interest statement: All authors declare that they have no relevant or material financial interests that relate to the research described in this paper.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author at chokaikyong@gmail.com. The data are not publicly available due to privacy or ethical restrictions.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aik Yong Chok, FRCS (Ed), MBBS, MMed, Surgeon, Department of Colorectal Surgery, Singapore General Hospital, 20 College Road, Singapore 169608, Singapore. chokaikyong@gmail.com
Received: November 29, 2022 Peer-review started: November 29, 2022 First decision: December 19, 2022 Revised: December 28, 2022 Accepted: January 9, 2023 Article in press: January 9, 2023 Published online: February 16, 2023 Processing time: 75 Days and 22.1 Hours
ARTICLE HIGHLIGHTS
Research background
Stenting as a bridge to curative surgery (SBTS) for obstructing colon cancer (OCC) has been associated with concerns regarding long-term oncological outcomes.
Research motivation
While SBTS may be associated with worse oncological outcomes, there are other competing risks that can affect colorectal cancer (CRC)-specific mortality among patients with OCC.
Research objectives
To evaluate the long-term oncological effects, recurrence patterns, survival outcomes, and CRC-specific mortality in patients who underwent SBTS for OCC.
Research methods
This study retrospectively examined long-term data from 62 patients who underwent SBTS at our institution over ten years from 2007 to 2016. CRC-specific mortality was evaluated by the competing risk analysis with cumulative incidence function. Fine-Gray analyses were performed to identify prognostic factors of CRC-specific mortality.
Research results
28 of 62 patients developed metastases after a median of 16 mo, with the peritoneum being the most prevalent (60.7%) metastatic site. In 46 mo of median follow-up, 26 (41.9%) patients died, of which 16 (61.5%) were CRC-specific deaths. Liver-only recurrence, peritoneum-only recurrence, and two or more recurrence sites were determined to be prognostic factors of CRC-specific mortality.
Research conclusions
The peritoneum was the most prevalent metastatic site among patients who underwent SBTS for OCC in this study. CRC-specific mortality most likely occurred in patients with liver-only recurrence, peritoneum-only recurrence, or two or more recurrence sites.
Research perspectives
The long-term recurrence pattern and factors contributing to CRC-specific mortality were reported.
