Management of obstructive colon cancer: Current status, obstacles, and future directions

Table 1 Oncological outcome after self-expandable metal stent placement as a bridge to surgery vs emergency surgery in malignant colonic obstruction

Ref.	Year	Study population	Study design	Location of obstructive cancer	Survival outcome
Matsuda et al[75]	2015	n = 1136: (1) BTS = 432; and (2) ES = 704	Meta-analysis: (1) 2 RCTs; (2) 2 prospective nonrandomized comparative studies; and (3) 7 retrospective comparative studies	Right- and left-sided	(1) No difference in disease-free survival and overall survival; and (2) No difference in recurrence
Ceresoli et al[76]	2017	n = 1333: (1) BTS = 688; (2) ES = 655	Meta-analysis: (1) 5 RCTs; (2) 3 prospective nonrandomized comparative studies; and (4) 9 retrospective comparative studies	Left-sided	(1) No difference in local recurrence and overall recurrence; (2) No difference in 3-yr and 5-yr recurrence; and (3) No difference in 3-yr and 5-yr mortality
Yang et al[53]	2018	n = 497: (1) BTS = 251; and (2) ES = 246	Meta-analysis: 8 RCTs	Left-sided	Higher tumor recurrence rate in BTS with an odds ratio of 1.79, 95%CI: 1.09–2.93
Amelung et al[51]	2018	n = 1919: (1) BTS = 938; and (2) ES = 981	Meta-analysis: (1) 5 RCTs; (2) 4 prospective nonrandomized comparative studies; and (3) 12 retrospective comparative studies	Left-sided	(1) No difference in locoregional recurrence and overall recurrence; (2) No difference in 3-yr and 5-yr disease-free survival; and (3) No difference in 3-yr and 5-yr overall survival
Foo et al[54]	2019	n = 448: (1) BTS = 222; and (2) ES = 226	Meta-analysis: 7 RCTs	Left-sided	(1) Overall recurrence rate: 37.0% in BTS vs 25.9% in ES; (2) The risk ratio of systemic recurrence 1.627 for BTS; and (3) No difference in 3-yr overall survival and disease-free survival
Arezzo et al[52] (ESCO trial)	2020	n = 115: (1) BTS = 56; and (2) ES = 59	RCT	Left-sided	No difference in 3-yr overall survival, time to progression, and disease-free survival

BTS: Bridge to surgery; ES: Emergency surgery; RCT: Randomized controlled trial; CI: Confidence interval.