Palliative Stent for Malignant Colonic Obstruction by Extracolonic Malignancy: A Comparison with Colorectal Cancer

Abstract

Palliative self-expandable metal stent placement for colonic obstruction arising from an extracolonic malignancy might be as useful as that for colorectal cancer, but data are limited. The purposes of this study were to investigate success and complications of stent placement in patients with extracolonic malignancy and to compare long-term clinical outcomes for an extracolonic malignancy group with those for a colorectal cancer group. We reviewed short-term and long-term outcomes for patients treated with palliative stents for colonic obstruction by extracolonic malignancy (n = 44) or unresectable colorectal cancer (n = 53) from January 2006 to March 2011. Neither the technical success (93.2 vs. 98.1 %, respectively; P = 0.326) nor clinical success (77.3 vs. 84.9 %, respectively; P = 0.433) of stent placement differed significantly in the two groups. Complications as a result of stent placement also differed only slightly in the two groups (perforation: 4.8 % (two cases) vs. 0 %, respectively; migration: 4.8 vs. 5.8 %, respectively, P = 0.343). With regard to long-term outcomes, although stent patency was shorter in the extracolonic malignancy group (P = 0.015), because overall survival in this group was also shorter (P = 0.018), it was sufficient for palliative purposes. Palliative stent placement was equally effective and safe for treatment of colonic obstruction arising from either extracolonic malignancy or unresectable colorectal cancer. Even in cases of colonic obstruction arising from extracolonic malignancy, stent placement should be considered as primary palliative therapy.