Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review
Approximately 10% of patients with colorectal cancer (CRC) develop malignant large bowel obstruction (MLBO) at diagnosis. Furthermore, for 35% of patients with MLBO, curative primary tumor resection is unfeasible because of locally advanced disease and comorbidities. The practice of placing a self-e...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japan Society of Coloproctology
2021-01-01
|
| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/5/1/5_2020-061/_pdf/-char/en |
| _version_ | 1818648238111064064 |
|---|---|
| author | Akihisa Matsuda Takeshi Yamada Satoshi Matsumoto Seiichi Shinji Ryo Ohta Hiromichi Sonoda Goro Takahashi Takuma Iwai Kohki Takeda Kumiko Sekiguchi Hiroshi Yoshida |
| author_facet | Akihisa Matsuda Takeshi Yamada Satoshi Matsumoto Seiichi Shinji Ryo Ohta Hiromichi Sonoda Goro Takahashi Takuma Iwai Kohki Takeda Kumiko Sekiguchi Hiroshi Yoshida |
| author_sort | Akihisa Matsuda |
| collection | DOAJ |
| description | Approximately 10% of patients with colorectal cancer (CRC) develop malignant large bowel obstruction (MLBO) at diagnosis. Furthermore, for 35% of patients with MLBO, curative primary tumor resection is unfeasible because of locally advanced disease and comorbidities. The practice of placing a self-expandable metallic stent (SEMS) has dramatically increased as an effective palliative treatment. Recent advances in systemic chemotherapy for metastatic CRC have significantly contributed to prolonging patients' prognosis and expanding the indications. However, the safety and efficacy of systemic chemotherapy in patients with SEMS have not been established. This review outlines the current status of this relatively new therapeutic strategy and future perspectives. Some reports on this topic have demonstrated that 1) systemic chemotherapy and the addition of molecular targeted agents contribute to prolonged survival in patients with SEMS; 2) delayed SEMS-related complications are a major concern, and this requires strict patient monitoring; however, primary tumor control by chemotherapy might result in decreased complications, especially regarding re-obstruction; and 3) using bevacizumab could be a risk factor for SEMS-related perforation, which may be lethal. Although this relatively new approach for unresectable stage IV obstructive CRC requires a well-planned clinical trial, this therapy could be promising for patients who are unideal candidates for emergency surgery and require immediate systemic chemotherapy. |
| first_indexed | 2024-12-17T01:15:15Z |
| format | Article |
| id | doaj.art-09fa9dec33c244c1a26db555052872e4 |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-12-17T01:15:15Z |
| publishDate | 2021-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-09fa9dec33c244c1a26db555052872e42022-12-21T22:09:01ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532021-01-015111010.23922/jarc.2020-0612020-061Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A ReviewAkihisa Matsuda0Takeshi Yamada1Satoshi Matsumoto2Seiichi Shinji3Ryo Ohta4Hiromichi Sonoda5Goro Takahashi6Takuma Iwai7Kohki Takeda8Kumiko Sekiguchi9Hiroshi Yoshida10Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Surgery, Nippon Medical School Chiba Hokusoh HospitalDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolDepartment of Surgery, Nippon Medical School Tama Nagayama HospitalDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical SchoolApproximately 10% of patients with colorectal cancer (CRC) develop malignant large bowel obstruction (MLBO) at diagnosis. Furthermore, for 35% of patients with MLBO, curative primary tumor resection is unfeasible because of locally advanced disease and comorbidities. The practice of placing a self-expandable metallic stent (SEMS) has dramatically increased as an effective palliative treatment. Recent advances in systemic chemotherapy for metastatic CRC have significantly contributed to prolonging patients' prognosis and expanding the indications. However, the safety and efficacy of systemic chemotherapy in patients with SEMS have not been established. This review outlines the current status of this relatively new therapeutic strategy and future perspectives. Some reports on this topic have demonstrated that 1) systemic chemotherapy and the addition of molecular targeted agents contribute to prolonged survival in patients with SEMS; 2) delayed SEMS-related complications are a major concern, and this requires strict patient monitoring; however, primary tumor control by chemotherapy might result in decreased complications, especially regarding re-obstruction; and 3) using bevacizumab could be a risk factor for SEMS-related perforation, which may be lethal. Although this relatively new approach for unresectable stage IV obstructive CRC requires a well-planned clinical trial, this therapy could be promising for patients who are unideal candidates for emergency surgery and require immediate systemic chemotherapy.https://www.jstage.jst.go.jp/article/jarc/5/1/5_2020-061/_pdf/-char/enobstructive colorectal cancermalignant large bowel obstructionself-expandable metallic stentchemotherapybevacizumab |
| spellingShingle | Akihisa Matsuda Takeshi Yamada Satoshi Matsumoto Seiichi Shinji Ryo Ohta Hiromichi Sonoda Goro Takahashi Takuma Iwai Kohki Takeda Kumiko Sekiguchi Hiroshi Yoshida Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review Journal of the Anus, Rectum and Colon obstructive colorectal cancer malignant large bowel obstruction self-expandable metallic stent chemotherapy bevacizumab |
| title | Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review |
| title_full | Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review |
| title_fullStr | Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review |
| title_full_unstemmed | Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review |
| title_short | Systemic Chemotherapy is a Promising Treatment Option for Patients with Colonic Stents: A Review |
| title_sort | systemic chemotherapy is a promising treatment option for patients with colonic stents a review |
| topic | obstructive colorectal cancer malignant large bowel obstruction self-expandable metallic stent chemotherapy bevacizumab |
| url | https://www.jstage.jst.go.jp/article/jarc/5/1/5_2020-061/_pdf/-char/en |
| work_keys_str_mv | AT akihisamatsuda systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT takeshiyamada systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT satoshimatsumoto systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT seiichishinji systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT ryoohta systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT hiromichisonoda systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT gorotakahashi systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT takumaiwai systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT kohkitakeda systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT kumikosekiguchi systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview AT hiroshiyoshida systemicchemotherapyisapromisingtreatmentoptionforpatientswithcolonicstentsareview |