Oncologic safety of colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction: Current evidence and prospects

Table 1 Short-term outcomes in randomized controlled trials of colonic stenting as a bridge to surgery

Ref.	Year	n	Perforation rate (%)	Stoma rate (%)	Morbidity (%)	Mortality (%)
Cheung et al[46]	2009	48	0	SEMS, 0; ES, 25, (P = 0.03)a	SEMS, 8; ES, 70; (P = N/A)	N/A
Van Hooft et al[51]	2011	98	12	SEMS, 57; ES, 66; (P = 0.35)	SEMS, 53; ES, 45; (P = 0.43)	SEMS, 19; ES, 17; (P = 0.84)
Pirlet et al[52]	2011	60	6.6	SEMS, 43; ES, 56; (P = 0.3)	SEMS, 50; ES, 56; (P = 1)	SEMS, 10; ES, 3; (P = N/A)
Alcántara et al[47]	2011	28	0	N/A	SEMS, 13; ES, 54; (P = 0.042)a	SEMS, 0; ES, 8; (P = 0.46)
Ho et al[50]	2012	39	0	SEMS, 10; ES, 31; (P = 0.12)	SEMS, 35; ES, 58; (P = 0.15)	SEMS, 0; ES, 16; (P = 0.1)
Ghazal et al[48]	2013	60	0	N/A	SEMS, 13; ES, 50; (P = 0.012)a	SEMS, 0; ES, 0
Arezzo et al[15]	2017	115	8.9	SEMS, 22; ES, 39; (P = 0.031)a	SEMS, 52; ES, 58; (P = 0.529)	SEMS, 7; ES, 5; (P = 0.943)
Elwan et al[49]	2020	601	0	SEMS, 20; ES, 27; (P = N/A)	SEMS, 23; ES, 40; (P = 0.029)a	N/A
CReST trial[53]	2022	2172	3.33	SEMS, 43; ES, 67; (P < 0.001)a	SEMS, 34; ES, 35; (P = 0.930)	SEMS, 4; ES, 6; (P = 0.480)

^aP<0.05

¹In this study, 85% of patients have left-sided malignant colonic obstruction, and 15% have right-sided malignant colonic obstruction.

²There are 217 potentially curative patients from 245 patients.

³The rate is reported in all patients (93% patients with potentially curable disease and 7%, palliative disease).

ES: Emergency surgery; SEMS: Self-expandable metal stent; N/A: Not available.

Table 2 Long-term outcomes in randomized controlled trials of colonic stenting as a bridge to surgery

Ref.	Year	n	Perforation rate (%)	Median F/U time (mo)	Recurrence (%)	Overall survival (OS, %)	Disease-free survival (DFS, %)
Alcántara et al[47]	2011	28	0	38	SEMS, 53; ES, 15; (P = 0.055)	5-yr OS: SEMS, 60; ES, 68; (P = 0.843)	Disease-free period (mo): SEMS, 25; ES, 27; (P = 0.096)
Tung et al[74]	2013	48	0	32	SEMS, 46; ES, 13; (P = 0.400)	5-yr OS: SEMS, 48; ES, 27; (P = 0.076)	5-yr DFS: SEMS, 52; ES, 48; (P = 0.630)
Ghazal et al[48]	2013	60	0	18	SEMS, 17; ES, 13; (P = 0.228)	N/A	N/A
Sloothaak et al[57]	2014	58	23	43	SEMS, 50; ES, 28; (P = N/A)	4-yr OS: SEMS, 58; ES, 67; (P = 0.478)	4-yr DFS: SEMS, 30; ES, 49; (P=0.007)a
Arezzo et al[75]	2020	115	8.9	37	SEMS, 28; ES, 36; (P = N/A)	3-yr OS: SEMS, 63; ES, 68; (P = 0.822)	3-yr DFS: SEMS, 50; ES, 56; (P = 0.972)
CReST trial[53]	2022	2171	3.32	N/A	3-yr recurrence: SEMS, 43; ES, 34; (P = 0.340)	3-yr OS: SEMS, 46; ES, 37; (P = 0.560)	N/A

^aP<0.05

¹There are 217 potentially curative patients from 245 patients.

²The rate is reported in all patients (93% patients with potentially curable disease and 7%, palliative disease).

ES: Emergency surgery; SEMS: Self-expandable metal stent; N/A: Not available.