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A peer-reviewed article of this preprint also exists.
Age, years, median (range) | 74.5 (63–85) |
Sex, male, n (%) | 111 (55.5) |
ECOG performance status, n (%) | |
0 | 22 (11.0) |
1 | 98 (49.0) |
2 | 32 (16.0) |
3 | 34 (17.0) |
4 | 14 (7.0) |
Etiology, n (%) | |
Colorectal cancer | 145 (72.5) |
Gastric cancer | 31 (15.5) |
Pancreatic cancer | 11 (5.5) |
Others† | 13 (6.5) |
CROSS, n (%) | |
0 | 68 (39.0) |
1 | 58 (29.0) |
2 | 31 (15.5) |
3 | 35 (17.5) |
4 | 8 (4.0) |
Symptoms of obstruction, n (%) | 195 (97.5) |
Deterioration of defecatory patterns | 184 (92.0) |
Bloating | 161 (80.5) |
Abdominal pain | 146 (73.0) |
Nausea / vomiting | 95 (47.5) |
Numbers of obstruction, n (%) † | |
1 | 196 (98.0) |
2 | 4 (2.0) |
Types of obstruction, n (%) † | |
Colonic | 137 (68.5) |
Extracolonic | 63 (31.5) |
Peritoneal dissemination, n (%) † | 54 (27.0) |
Length of obstruction, cm, median (range) | 4.0 (3–6) |
Location of obstruction, n (%) | |
Left side / Right side | 142 (69.6) / 62 (30.4) |
Rectum | 26 (12.7) |
Rectosigmoid junction | 30 (14.7) |
Sigmoid colon | 49 (24.0) |
Sigmoid-descending colon junction | 15 (7.4) |
Descending colon | 22 (10.8) |
Splenic flexure | 19 (9.3) |
Transverse colon | 28 (13.7) |
Hepatic flexure | 5 (2.5) |
Ascending colon | 8 (3.9) |
Cecum | 1 (0.5) |
Ileocecal junction | 1 (0.5) |
Numbers of stent placement, n (%) | |
Single stent | 190 (95.9%) |
Double stents | 7 (3.5) |
No stent placement (technical failure) | 3 (1.5) |
Length of the stent, n (%) † | |
6 cm | 108 (52.9) |
9 cm | 73 (35.8) |
12 cm | 23 (11.3) |
Diameter of the stent, n (%) † | |
22 mm | 183 (89.7) |
25 mm | 21 (10.3) |
Balloon dilation before stent placement, n (%) | 1 (0.5) |
Procedure time, min, median (range) | 30 (6–170) |
Technical success, n (%) | 197 (98.5) |
Clinical success, n (%) | 189 (94.5) |
Cause of clinical failure, n (%) | |
Insufficient stent expansion | 3 (1.5) |
Stent kinking | 1 (0.5) |
Stent migration | 1 (0.5) |
Proximal-bowel perforation | 1 (0.5) |
Perforation due to obstructive colitis | 1 (0.5) |
Proximal small bowel obstruction | 1 (0.5) |
Early onset (≤7 days) (n = 200) |
Late onset (7 days <) (n = 200) |
|
---|---|---|
Total, n (%) | 28 (14.0) | 66 (33.0) |
Perforation | 4 (2.0) | 10 (5.0) |
During the endoscopic procedure | 1 (0.5) | 0 |
At stent and its surroundings after stent placement | 2 (1.0) | 5 (2.5) |
At other sites after stent placement | 1 (1.0) | 1 (0.5) |
Unknown of perforation sites after stent placement | 0 | 4 (2.0) |
Stent migration | 1 (0.5) | 9 (4.5) |
Stent obstruction | 5 (2.5) | 24 (12.0) |
Major bleeding | 0 (0) | 1 (0.5) |
Minor bleeding | 3 (1.5) | 2 (1.0) |
Insufficient stent expansion | 1 (0.5) | 0 (0) |
Infection / fever | 6 (3.0) | 4 (2.0) |
Abdominal pain | 8 (4.0) | 4 (2.0) |
Tenesmus | 3 (1.5) | 1 (0.5) |
Fecal incontinence | 0 (0) | 1 (0.5) |
Ileus associated with poor peristalsis | 1 (0.5) | 0 (0) |
Vomiting without obstruction | 0 (0) | 2 (1.0) |
Gastrointestinal obstruction at proximal site | 3 (1.5) | 12 (6.0) |
Interstitial pneumonitis | 0 (0) | 1 (0.5) |
Regimen | N | |
---|---|---|
Colorectal cancer | S-1 | 3 |
Capecitabine | 1 | |
UFT + Leucovorin | 2 | |
Trifluridine/Tipiracil | 1 | |
FOLFIRI | 3 | |
FOLFOX | 5 | |
SOX | 1 | |
CAPOX | 9 | |
(anti-VEGF) | 5-fluorouracil + Leucovorin + Bevacizumab | 1 |
FOLFIRI + Bevacizumab | 2 | |
CAPIRI + Bevacizumab | 1 | |
CAPOX + Bevacizumab | 1 | |
(anti-EGFR) | Cetuximab | 1 |
Panitumumab | 1 | |
Irinotecan + Cetuximab | 4 | |
Irinotecan + Panitumumab | 1 | |
FOLFIRI + Panitumumab | 1 | |
FOLFOX + Panitumumab | 5 | |
Gastric cancer | S-1 | 2 |
Irinotecan | 2 | |
Docetaxel | 1 | |
Nab-Paclitaxel | 3 | |
Paclitaxel | 5 | |
Cisplatin + Irinotecan | 2 | |
5-fluorouracil + Methotrexate | 2 | |
S-1 + Cisplatin | 1 | |
S-1 + Irinotecan | 1 | |
S-1 + Docetaxel | 1 | |
S-1 + iv. Paclitaxel + ip. Paclitaxel | 2 | |
SOX + ip. Paclitaxel | 1 | |
Pancreatic cancer | S-1 | 1 |
Ovarian cancer | Carboplatin + Paclitaxel | 1 |
SOX + ip. Paclitaxel | 1 |
Univariate analysis | |||
---|---|---|---|
Variables | N | Hazard ratio (95%CI) |
P value |
Age ≥ 70 | 73 | 1.04 (0.33–3.22) | 0.95 |
Age < 70 | 127 | 1 | |
Male | 111 | 2.10 (0.64–6.94) | 0.21 |
Female | 89 | 1 | |
Etiology | |||
Colorectal cancer | 145 | 0.66 (0.21–2.07) | 0.48 |
Non-colorectal cancer | 55 | 1 | |
Types of obstruction | |||
Colonic | 137 | 0.59 (0.20–1.78) | 0.35 |
Extracolonic | 63 | 1 | |
Length of stent | 0.03 | ||
6 cm | 108 | 1 | |
9 cm | 73 | 3.13 (0.76–12.96) | 0.11 |
12 cm | 23 | 7.37 (1.53–35.58) | 0.01 |
Chemotherapy after SEMS placement (+) | 56 | 0.41 (0.09–1.88) | 0.25 |
Chemotherapy after SEMS placement (-) | 144 | 1 | |
Anti-VEGF antibody drug (+) | 5 | 3.50 (0.36–33.62) | 0.28 |
Anti-VEGF antibody drug (-) | 195 | 1 | |
Anti-EGFR antibody drug (+) | 13 | - | - |
Study | Year | Country | Design | Stent | N | Technical success |
Clinical success |
Perforation N (%) |
---|---|---|---|---|---|---|---|---|
van Hooft JE [22] | 2008 | Netherlands | Prospective | WallFlex | 10 | 90% | 90% | 6 (60.0) |
Kim JH [24] | 2011 | Korea | Retrospective | WallFlex | 108 | 89% | 86.1% | 6 (6.3) |
Meisner S [25] | 2012 | Denmark | Prospective | WallFlex | 255 | 91.3% | 76.9% | 13 (5.1) |
Cheung DY [21] | 2012 | Korea | Prospective | WallFlex | 28 | 100% | 100% | 1 (3.6) |
Present study | 2023 | Japan | Prospective | WallFlex | 200 | 98.5% | 94.5% | 14 (7.0) |
Total | 601 | 96.7% | 85.7% | 40 (6.7) | ||||
Cheung DY [21] | 2012 | Korea | Prospective | D-type | 30 | 100% | 93.3% | 0 (0) |
Yoshida S [12] | 2013 | Japan | Prospective | D-type | 33 | 100% | 97% | 0 (0) |
Total | 63 | 100% | 95.2% | 0 (0) | ||||
Sausa M [26] | 2017 | Portugal | Retrospective | Hanaro | 45 | 97.8% | 96.5% | 4 (8.9) |
Franz S[27] | 2018 | USA | Retrospective | Wallstent | 187 | 76% | 54.5% | 7 (3.7) |
Small AJ [28] | 2010 | USA | Retrospective | Various | 168 | 96.0% | 95.8% | 15 (13.3) |
Kim BK [29] | 2012 | Korea | Retrospective | Various | 111 | 73.9% | 54.1% | 8 (7.9) |
Kim BC [15] | 2012 | Korea | Retrospective | Various | 102 | 87.0% | 77.8% | 3 (2.9) |
Moon SJ [30] | 2014 | Korea | Retrospective | Various | 97 | 95.9% | 81.4% | 2 (2.1) |
Van den Berg [31] | 2015 | Netherlands | Prospective | Various | 48 | 91.6% | 87.5% | 8 (16.7) |
Kwon SJ [32] | 2021 | Korea | Retrospective | Various | 495 | 92.9% | 83.5% | 19 (3.8) |
Naruse N [33] | 2022 | Japan | Retrospective | Various | 42 | 97.6% | 88.1% | 4 (9.5) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
Submitted:
23 May 2023
Posted:
25 May 2023
You are already at the latest version
A peer-reviewed article of this preprint also exists.
Submitted:
23 May 2023
Posted:
25 May 2023
You are already at the latest version
Age, years, median (range) | 74.5 (63–85) |
Sex, male, n (%) | 111 (55.5) |
ECOG performance status, n (%) | |
0 | 22 (11.0) |
1 | 98 (49.0) |
2 | 32 (16.0) |
3 | 34 (17.0) |
4 | 14 (7.0) |
Etiology, n (%) | |
Colorectal cancer | 145 (72.5) |
Gastric cancer | 31 (15.5) |
Pancreatic cancer | 11 (5.5) |
Others† | 13 (6.5) |
CROSS, n (%) | |
0 | 68 (39.0) |
1 | 58 (29.0) |
2 | 31 (15.5) |
3 | 35 (17.5) |
4 | 8 (4.0) |
Symptoms of obstruction, n (%) | 195 (97.5) |
Deterioration of defecatory patterns | 184 (92.0) |
Bloating | 161 (80.5) |
Abdominal pain | 146 (73.0) |
Nausea / vomiting | 95 (47.5) |
Numbers of obstruction, n (%) † | |
1 | 196 (98.0) |
2 | 4 (2.0) |
Types of obstruction, n (%) † | |
Colonic | 137 (68.5) |
Extracolonic | 63 (31.5) |
Peritoneal dissemination, n (%) † | 54 (27.0) |
Length of obstruction, cm, median (range) | 4.0 (3–6) |
Location of obstruction, n (%) | |
Left side / Right side | 142 (69.6) / 62 (30.4) |
Rectum | 26 (12.7) |
Rectosigmoid junction | 30 (14.7) |
Sigmoid colon | 49 (24.0) |
Sigmoid-descending colon junction | 15 (7.4) |
Descending colon | 22 (10.8) |
Splenic flexure | 19 (9.3) |
Transverse colon | 28 (13.7) |
Hepatic flexure | 5 (2.5) |
Ascending colon | 8 (3.9) |
Cecum | 1 (0.5) |
Ileocecal junction | 1 (0.5) |
Numbers of stent placement, n (%) | |
Single stent | 190 (95.9%) |
Double stents | 7 (3.5) |
No stent placement (technical failure) | 3 (1.5) |
Length of the stent, n (%) † | |
6 cm | 108 (52.9) |
9 cm | 73 (35.8) |
12 cm | 23 (11.3) |
Diameter of the stent, n (%) † | |
22 mm | 183 (89.7) |
25 mm | 21 (10.3) |
Balloon dilation before stent placement, n (%) | 1 (0.5) |
Procedure time, min, median (range) | 30 (6–170) |
Technical success, n (%) | 197 (98.5) |
Clinical success, n (%) | 189 (94.5) |
Cause of clinical failure, n (%) | |
Insufficient stent expansion | 3 (1.5) |
Stent kinking | 1 (0.5) |
Stent migration | 1 (0.5) |
Proximal-bowel perforation | 1 (0.5) |
Perforation due to obstructive colitis | 1 (0.5) |
Proximal small bowel obstruction | 1 (0.5) |
Early onset (≤7 days) (n = 200) |
Late onset (7 days <) (n = 200) |
|
---|---|---|
Total, n (%) | 28 (14.0) | 66 (33.0) |
Perforation | 4 (2.0) | 10 (5.0) |
During the endoscopic procedure | 1 (0.5) | 0 |
At stent and its surroundings after stent placement | 2 (1.0) | 5 (2.5) |
At other sites after stent placement | 1 (1.0) | 1 (0.5) |
Unknown of perforation sites after stent placement | 0 | 4 (2.0) |
Stent migration | 1 (0.5) | 9 (4.5) |
Stent obstruction | 5 (2.5) | 24 (12.0) |
Major bleeding | 0 (0) | 1 (0.5) |
Minor bleeding | 3 (1.5) | 2 (1.0) |
Insufficient stent expansion | 1 (0.5) | 0 (0) |
Infection / fever | 6 (3.0) | 4 (2.0) |
Abdominal pain | 8 (4.0) | 4 (2.0) |
Tenesmus | 3 (1.5) | 1 (0.5) |
Fecal incontinence | 0 (0) | 1 (0.5) |
Ileus associated with poor peristalsis | 1 (0.5) | 0 (0) |
Vomiting without obstruction | 0 (0) | 2 (1.0) |
Gastrointestinal obstruction at proximal site | 3 (1.5) | 12 (6.0) |
Interstitial pneumonitis | 0 (0) | 1 (0.5) |
Regimen | N | |
---|---|---|
Colorectal cancer | S-1 | 3 |
Capecitabine | 1 | |
UFT + Leucovorin | 2 | |
Trifluridine/Tipiracil | 1 | |
FOLFIRI | 3 | |
FOLFOX | 5 | |
SOX | 1 | |
CAPOX | 9 | |
(anti-VEGF) | 5-fluorouracil + Leucovorin + Bevacizumab | 1 |
FOLFIRI + Bevacizumab | 2 | |
CAPIRI + Bevacizumab | 1 | |
CAPOX + Bevacizumab | 1 | |
(anti-EGFR) | Cetuximab | 1 |
Panitumumab | 1 | |
Irinotecan + Cetuximab | 4 | |
Irinotecan + Panitumumab | 1 | |
FOLFIRI + Panitumumab | 1 | |
FOLFOX + Panitumumab | 5 | |
Gastric cancer | S-1 | 2 |
Irinotecan | 2 | |
Docetaxel | 1 | |
Nab-Paclitaxel | 3 | |
Paclitaxel | 5 | |
Cisplatin + Irinotecan | 2 | |
5-fluorouracil + Methotrexate | 2 | |
S-1 + Cisplatin | 1 | |
S-1 + Irinotecan | 1 | |
S-1 + Docetaxel | 1 | |
S-1 + iv. Paclitaxel + ip. Paclitaxel | 2 | |
SOX + ip. Paclitaxel | 1 | |
Pancreatic cancer | S-1 | 1 |
Ovarian cancer | Carboplatin + Paclitaxel | 1 |
SOX + ip. Paclitaxel | 1 |
Univariate analysis | |||
---|---|---|---|
Variables | N | Hazard ratio (95%CI) |
P value |
Age ≥ 70 | 73 | 1.04 (0.33–3.22) | 0.95 |
Age < 70 | 127 | 1 | |
Male | 111 | 2.10 (0.64–6.94) | 0.21 |
Female | 89 | 1 | |
Etiology | |||
Colorectal cancer | 145 | 0.66 (0.21–2.07) | 0.48 |
Non-colorectal cancer | 55 | 1 | |
Types of obstruction | |||
Colonic | 137 | 0.59 (0.20–1.78) | 0.35 |
Extracolonic | 63 | 1 | |
Length of stent | 0.03 | ||
6 cm | 108 | 1 | |
9 cm | 73 | 3.13 (0.76–12.96) | 0.11 |
12 cm | 23 | 7.37 (1.53–35.58) | 0.01 |
Chemotherapy after SEMS placement (+) | 56 | 0.41 (0.09–1.88) | 0.25 |
Chemotherapy after SEMS placement (-) | 144 | 1 | |
Anti-VEGF antibody drug (+) | 5 | 3.50 (0.36–33.62) | 0.28 |
Anti-VEGF antibody drug (-) | 195 | 1 | |
Anti-EGFR antibody drug (+) | 13 | - | - |
Study | Year | Country | Design | Stent | N | Technical success |
Clinical success |
Perforation N (%) |
---|---|---|---|---|---|---|---|---|
van Hooft JE [22] | 2008 | Netherlands | Prospective | WallFlex | 10 | 90% | 90% | 6 (60.0) |
Kim JH [24] | 2011 | Korea | Retrospective | WallFlex | 108 | 89% | 86.1% | 6 (6.3) |
Meisner S [25] | 2012 | Denmark | Prospective | WallFlex | 255 | 91.3% | 76.9% | 13 (5.1) |
Cheung DY [21] | 2012 | Korea | Prospective | WallFlex | 28 | 100% | 100% | 1 (3.6) |
Present study | 2023 | Japan | Prospective | WallFlex | 200 | 98.5% | 94.5% | 14 (7.0) |
Total | 601 | 96.7% | 85.7% | 40 (6.7) | ||||
Cheung DY [21] | 2012 | Korea | Prospective | D-type | 30 | 100% | 93.3% | 0 (0) |
Yoshida S [12] | 2013 | Japan | Prospective | D-type | 33 | 100% | 97% | 0 (0) |
Total | 63 | 100% | 95.2% | 0 (0) | ||||
Sausa M [26] | 2017 | Portugal | Retrospective | Hanaro | 45 | 97.8% | 96.5% | 4 (8.9) |
Franz S[27] | 2018 | USA | Retrospective | Wallstent | 187 | 76% | 54.5% | 7 (3.7) |
Small AJ [28] | 2010 | USA | Retrospective | Various | 168 | 96.0% | 95.8% | 15 (13.3) |
Kim BK [29] | 2012 | Korea | Retrospective | Various | 111 | 73.9% | 54.1% | 8 (7.9) |
Kim BC [15] | 2012 | Korea | Retrospective | Various | 102 | 87.0% | 77.8% | 3 (2.9) |
Moon SJ [30] | 2014 | Korea | Retrospective | Various | 97 | 95.9% | 81.4% | 2 (2.1) |
Van den Berg [31] | 2015 | Netherlands | Prospective | Various | 48 | 91.6% | 87.5% | 8 (16.7) |
Kwon SJ [32] | 2021 | Korea | Retrospective | Various | 495 | 92.9% | 83.5% | 19 (3.8) |
Naruse N [33] | 2022 | Japan | Retrospective | Various | 42 | 97.6% | 88.1% | 4 (9.5) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
Takashi Sasaki
et al.
JCM,
2021
© 2024 MDPI (Basel, Switzerland) unless otherwise stated