The Efficacy of Self-Expanding Metal Stents for Colorectal Obstruction with Unresectable Stage IVB Colorectal Cancer

Abstract

Acute colorectal obstruction with stage IVB colorectal cancer has a poor prognosis and short life expectancy. The effectiveness of self-expanding metal stents (SEMS) has been demonstrated in colorectal cancer patients with obstruction. However, little is known about the palliative efficacy of stent placement inpatients with unresectable colorectal cancer. The medical records of patients who received SEMS for stage IVB colorectal cancer with acute colorectal obstruction between March 2004 and July 2010 were retrospectively reviewed. A total of 24 patients with unresectable Stage IVB colorectal cancer with acute colorectal obstruction were enrolled in this study. Twenty-four patients received SEMS placement during the study period. The mean age of the patients was 63.0 years (range 35-84 years). Fifteen patients were male and nine were female. The most common obstructive lesion was in the sigmoid colon (70.8%), including the sigmoid-descending and rectosigmoid junctions. Un-covered SEMS were used in 62.5% of patients. On the first attempt, the technical success rate of SEMS was 95.8%. The estimated duration of primary stent patency and overall survival periods after SEMS were 332.0 and 231.8 days, respectively. SEMS insertion may be a useful therapeutic choice for acute colorectal obstruction in patients with unresectable stage IVB colorectal cancer.