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.

Resection or stenting in the treatment of symptomatic advanced metastatic rectal cancer: a dilemma / Fiori, E.; Crocetti, D.; Lamazza, A.; De Felice, F.; Tarallo, M.; Sterpetti, A. V.; Mingoli, A.; Sapienza, P.; De Toma, G.. - In: ANTICANCER RESEARCH. - ISSN 0250-7005. - 39:12(2019), pp. 6781-6786. [10.21873/anticanres.13893]

Resection or stenting in the treatment of symptomatic advanced metastatic rectal cancer: a dilemma

Fiori E.
Primo
;
Crocetti D.
Secondo
;
Lamazza A.;De Felice F.;Tarallo M.;Sterpetti A. V.;Mingoli A.;Sapienza P.
Penultimo
;
De Toma G.
Ultimo
2019

Abstract

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.
2019
rectal cancer; stent positioning; targeted therapy; adenocarcinoma; adult; aged; aged, 80 and over; antineoplastic combined chemotherapy protocols; camptothecin; combined modality therapy; female; fluorouracil; humans; intestinal obstruction; leucovorin; male; middle aged; molecular targeted therapy; organoplatinum compounds; prospective studies; rectal neoplasms; survival rate; self expandable metallic stents
01 Pubblicazione su rivista::01a Articolo in rivista
Resection or stenting in the treatment of symptomatic advanced metastatic rectal cancer: a dilemma / Fiori, E.; Crocetti, D.; Lamazza, A.; De Felice, F.; Tarallo, M.; Sterpetti, A. V.; Mingoli, A.; Sapienza, P.; De Toma, G.. - In: ANTICANCER RESEARCH. - ISSN 0250-7005. - 39:12(2019), pp. 6781-6786. [10.21873/anticanres.13893]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1345728
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