Critical appraisal of oncological safety of stent as bridge to surgery in left-sided obstructing colon cancer; a systematic review and meta-analysis
SourceCritical Reviews in Oncology Hematology, 131, (2018), pp. 66-75
Article / Letter to editor
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Critical Reviews in Oncology Hematology
SubjectRadboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences
This meta-analysis aims to determine the long-term oncological outcomes of SEMS as bridge to surgery (BTS) versus emergency surgery (ES). A systematic search without restrictions was conducted, and all studies comparing SEMS with ES reporting on long-term outcomes were included. Methodological quality was assessed using the appropriate tools. Twenty-one comparative studies were selected, reporting on 1919 patients. Meta-analysis showed no significant difference regarding three- and five-year overall survival (OR = 0.85 (0.68-1.08) and OR = 1.04 (0.68-1.57), respectively), disease-free survival (OR = 0.96 (0.73-1.26) and OR = 0.86 (0.54-1.36), respectively) and local recurrence rate (OR = 1.32 (0.78-2.23)). Permanent stomas were significantly lower in the SEMS group (OR 0.49 (0.32-0.74)). Sensitivity analysis on three-year survival showed opposite outcomes, with a trend towards worse survival in the SEMS group when only RCTs are taken into account. In conclusion, when in experienced hands, SEMS placement as BTS seems oncologically safe.
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