Long-term outcomes after stenting as a “bridge to surgery” for the management of acute obstruction secondary to colorectal cancer

Table 1 Data of recurrence and survival in studies comparing self-expandable metallic stents by-pass to elective surgery and emergency operation for obstructive colorectal cancer

Ref.	Perforation rate	RecurrenceSEMS vs EO	Survival SEMS vs EO
Ghazal et al[43]	0	RR: 17.2% vs 13.3%; P = 0.228
Saida et al[45]	-	RR of Dukes B: 23% vs 14%; P = 0.51)	3 yr-OS: 48% vs 50%
			5 yr-OS: 40% vs 44%. Log-rank test: P = 0.84
			DFS of Dukes B: Log-rank test: P = 0.71
Alcántara et al[46]	0	RR: 53.3% vs 15.3%; P = 0.055	DFS: 25.4 m vs 27 m; P = 0.096
			OS: Log-rank test: P = 0.843
Tung et al[34]	0		5 yr-OS: 48% vs 27%; P = 0.076
			5 yr-DFS: 52% vs 48%; P = 0.63
Pessione et al[47]	0		2 yr-OS: 66.6% vs 28.5%
Gianotti et al[40]	1.2%		HR: 0.412 P = 0.007
			OS: Log-rank test: P = 0.004
van den Berg et al[42]	1.7%	5 yr-RR of stage I-II: 33% vs 26%; P = 0.81	5 yr-OS of stage I-II: Log-rank test: P = 0.85
		5 yr-RR of stage III: 35% vs 51%; P = 0.24	5 yr-OS of stage III: Log-rank test: P = 0.48
		3 yr-RR of stage IV: 32% vs 58%; P = 0.30	5 yr-OS of stage IV: Log-rank test: P = 0.08
Kim et al[29]	3.3%	RR: 35% vs 35%; P = 1.000	5 yr-OSR: 67.2% vs 61.6%; P = 0.386
		LR: 0% vs 1.6%	5 yr-DFSR: 61.2% vs 60%; P = 0.932
			5 yr-CRSR: 77% vs 65%; P = 0.233
Sabbagh et al[33]	4.2%	Patients with no perforation or metastases	Patients with no perforation or metastases
		34% vs 28 %	5 yr-OSR: 30% vs 67%; P = 0.001
			5 yr-DFSR: 27% vs 43%; P = 0.16
			5 yr-CSMR: 29% vs 22%; P = 0.62
Kavanagh et al[44]	4.3%	RR 17.3% vs 23%	OS: Log-rank test: P = 0.13
			CSM: Log-rank test: P = 0.21
			CSMR: 13% vs 15.3%
Dastur et al[48]	5.2%		3 yr-OS: 48% vs 46%; P = 0.54
Gorissen et al[25]	8%	RR: 31.6 vs 28.2; P = 0.824	CSMR: 24.1% vs 37.2%; P = 0.180
		LRR: 23% vs 15%; P = 0.443
		LRR in young patients:
		32% vs 8%; Log-rank test: P = 0.038
Sloothaak et al[32]	11.5%		4 yr-DFS: 30% vs 49%: Log-rank test: P = 0.149
			4 yr-DSS: 66% vs 87%: Log-rank test: P = 0.061
			4 yr-OS: 58% vs 67%: Log-rank test: P = 0.468
			Stent-related perforation vs no perforation
			4 yr-DFS: 0% vs 45%: Log-rank test: P = 0.007
			4 yr-DSS: 60% vs 69%: Log-rank test: P = 0.099
			4 yr-OS: 50% vs 62%: Log-rank test: P = 0.478
Erichsen et al[49]	Non-reported	5 yr-RR: 38% vs 29%;	5yOSR: 49% vs 40%; OR: 0.98; 95%CI 0.9-1.07
		OR: 1.12; 95%CI: 0.99-1.28
Choi et al[50]	Non-reported		5yOSR: 97.8% vs 94.3%; P = 0.469

RR: Recurrence rate; LRR: Local recurrence rate; OS: Overall survival; OSR: Overall survival rate; DFS: Disease-free survival; DFSR: Disease-free survival rate; CRSR: Cancer related survival rate; CSM: Cancer-specific mortality; CSMR: Cancer-specific mortality rate; DSS: Disease-specific survival; EO: Emergency operation; SEMS: Self-expandable metallic stents.

Table 2 Data of lymph node count, administration of adjuvant chemotherapy and laparoscopic surgery in studies comparing self-expandable metallic stents by-pass to elective surgery and emergency operation for obstructive colorectal cancer

Ref.	Lymph node count	Adjuvant chemotherapy	Laparoscopic surgery
	SEMS vs EO	SEMS vs EO	SEMS vs EO
Ghazal et al[43]		80% vs 76.7%
Saida et al[45]		66% vs 53%; P = 0.54
Alcántara et al[46]	17.7 vs 24.2; P = 0.099
Tung et al[34]	23 vs 11; P = 0.005	75% vs 54%; P = 0.2
Gianotti et al[40]	23 vs 18; P = 0.08	46.7% vs 34%; P = 0.28	38.7% vs 0%; P = 0.000
van den Berg et al[42]	Lymph node harvest > 12	39 vs 39; P = NS
	62.7% vs 60.7%; P = NS
Kim et al[29]	28.9 vs 24.4; P = 0.25	84% vs 65.7%; P = 0.085
Sabbagh et al[33]	22 vs 15; P = 0.002	56.2% vs 43.6%; P = 0.28
Kavanagh et al[44]	17 vs 17; P = 0.29	36% vs 46%; P = 0.29	27% vs 12%; P = 0.1
Gorissen et al[25]		41.6 vs 25.6%; P = 0.13	59.6% vs 23%; P = 0.001
Sloothaak et al[32]	15 vs 13; P = 0.180	13 vs 15; P = 1.000

SEMS: Self-expandable metallic stents; EO: Emergency operation.