The factors influencing long-term outcomes of stenting for malignant colorectal obstruction in elderly group in community medicine.
PURPOSE
Malignant bowel obstruction is a complication of colorectal carcinoma or metastasis from other carcinoma, and it causes significant damage on the condition of elderly patients; however, the self-expandable metallic stents (SEMSs) have been effectively used either for palliation or for bridging to the surgical procedure for this condition. The aim of this study was to investigate the factors influencing long-term outcomes of old-aged patients with SEMS for large bowel obstruction to develop the strategy for those patients in the community medicine.


METHODS
We performed a retrospective review of 42 patients with a median age of 83.0 years (range, 65-99 years), who underwent SEMS placement for malignant colorectal obstruction between 2006 and 2015 in our hospital. Univariate and multivariate logistic regressions were performed on data from the patients to assess the factors affecting 6-month survival without stent dysfunction.


RESULTS
The study population comprised 24 females (57.1%) and 18 males (42.9%). Of these, 38 patients (90.5%) received SEMS as palliation, whereas 4 patients (9.5%) underwent subsequent surgery. SEMSs were successfully inserted in 97.6% of patients. The median duration of follow-up was 205.0 days (range, 20-1377 days). On multivariate analysis, shorter stents (< 10 cm) yielded better outcomes than longer stents (≥ 10 cm) (P = 0.041), and the Cox proportional hazard model also indicated that shorter stents (P = 0.036) predicted longer event-free survival.


CONCLUSIONS
Elderly patients with malignant bowel obstruction receiving shorter stents had longer event-free survival after stenting with better general condition.
['Imai|Michitaka|M|', 'Kamimura|Kenya|K|', 'Takahashi|Yoshifumi|Y|', 'Sato|Toshihiro|T|', 'Isokawa|Osamu|O|', 'Maruyama|Masaki|M|', 'Kobayashi|Takamasa|T|', 'Hayashi|Kazunao|K|', 'Terai|Shuji|S|']
D000368:Aged D000369:Aged, 80 and over D015179:Colorectal Neoplasms D003154:Community Medicine D005260:Female D006801:Humans D007415:Intestinal Obstruction D053208:Kaplan-Meier Estimate D008297:Male D015999:Multivariate Analysis D010166:Palliative Care D000069322:Self Expandable Metallic Stents D013997:Time Factors D016896:Treatment Outcome
Community medicine Elderly patients Self-expandable metallic stent Colonic obstruction Colonic stent Colorectal cancer