RT Journal Article
SR Electronic
T1 Resection or Stenting in the Treatment of Symptomatic Advanced Metastatic Rectal Cancer: A Dilemma
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 6781
OP 6786
DO 10.21873/anticanres.13893
VO 39
IS 12
A1 ENRICO FIORI
A1 DANIELE CROCETTI
A1 ANTONIETTA LAMAZZA
A1 FRANCESCA DE FELICE
A1 MARIARITA TARALLO
A1 ANTONIO V. STERPETTI
A1 ANDREA MINGOLI
A1 PAOLO SAPIENZA
A1 GIORGIO DE TOMA
YR 2019
UL http://ar.iiarjournals.org/content/39/12/6781.abstract
AB Background/Aim: Patients affected with Stage IV colorectal cancer and unresectable metastases represent a heterogeneous group. Resection of the primary tumor or stent positioning followed by chemotherapy and/or targeted therapies still represent a difficult choice for surgeons. Patients and Methods: From February 2013 to September 2019, 46 patients were enrolled into a prospective randomized open label parallel trial presenting with Stage IVA and IVB rectal cancer, unresectable metastases and symptoms of subacute large bowel obstruction. Our population was divided into two groups: Group 1 included 20 patients who underwent placement of a self-expandable metal stent and Group 2 included 26 patients in whom primary tumor resection was performed. Results: One-year actuarial survival rate of Group 1 was significantly lower compared to Group 2. Overall 17 patients had survival longer than 1-year (3 in Group 1 and 14 in Group 2). Cox regression analysis showed that endoscopic stent positioning and the suspension of the chemotherapy because of deterioration of liver function tests were the two most important factors negatively influencing survival. Conclusion: Patients affected with stage IVA and IVB rectal cancer and symptoms of bowel obstruction had a significant longer survival rate when submitted to surgical rectal resection followed by chemotherapy.