Suzuki H, Tsujinaka S, Sato Y, Miura T, Shibata C. Oncologic impact of colonic stents for obstructive left-sided colon cancer. World J Clin Oncol 2023; 14(1): 1-12 [PMID: 36699626 DOI: 10.5306/wjco.v14.i1.1]
Corresponding Author of This Article
Shingo Tsujinaka, MD, Associate Professor, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Miyagi, Japan. tsujinakas@tohoku-mpu.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
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/
Hideyuki Suzuki, Shingo Tsujinaka, Yoshihiro Sato, Tomoya Miura, Chikashi Shibata, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Miyagi, Japan
Author contributions: Suzuki H wrote the paper; Tsujinaka S supervised and critically revised the manuscript; Sato Y, Miura T, and Shibata C critically revised the manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest in regards to this article.
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: Shingo Tsujinaka, MD, Associate Professor, Department of Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536, Miyagi, Japan. tsujinakas@tohoku-mpu.ac.jp
Received: September 19, 2022 Peer-review started: September 19, 2022 First decision: November 25, 2022 Revised: December 7, 2022 Accepted: December 31, 2022 Article in press: December 31, 2022 Published online: January 24, 2023 Processing time: 113 Days and 12.4 Hours
Abstract
Colonic stenting has had a significant positive impact on the management of obstructive left-sided colon cancer (OLCC) in terms of both palliative treatment and bridge-to-surgery (BTS). Notably, many studies have convincingly demonstrated the effectiveness of stenting as a BTS, resulting in improvements in short-term outcomes and quality of life, safety, and efficacy in subsequent curative surgery, and increased cost-effectiveness, whereas the safety of chemotherapy after stenting and the long-term outcomes of stenting as a BTS are controversial. Several studies have suggested an increased risk of perforation in patients receiving bevacizumab chemotherapy after colonic stenting. In addition, several pathological analyses have suggested a negative oncological impact of colonic stenting. In contrast, many recent studies have demonstrated that colonic stenting for OLCC does not negatively impact the safety of chemotherapy or long-term oncological outcomes. The updated version of the European Society of Gastrointestinal Endoscopy guidelines released in 2020 included colonic stenting as a BTS for OLCC as a recommended treatment. It should be noted that the experience of endoscopists is involved in determining technical and clinical success rates and possibly oncological outcomes. This review discusses the positive and negative impacts of colonic stenting on OLCC treatment, particularly in terms of oncology.
Core Tip: Colonic stenting has been widely used in the management of obstructive left-sided colon cancer, and its effectiveness has been convincingly demonstrated. However, some controversies remain, including the safety of chemotherapy after stenting and the long-term outcomes of stenting as a bridge to surgery (BTS). Nevertheless, many recent studies have demonstrated that colonic stenting exerts no negative impact on long-term oncological outcomes, and this technique is recommended as a BTS in the European Society of Gastrointestinal Endoscopy guidelines. Herein, we review and discuss the positive and negative effects of colonic stenting in colon cancer treatment.
