Abstract 4973
Background
Malignant bowel obstruction can occur in 18% of cases. SEMS can be an alternative to surgery. BV has been associated with bowel perforation but data on the safety of SEMS for occlusive colon cancer during BV-containing regimens are lacking.
Methods
Retrospective analysis of 136 patients with malignant bowel obstruction who underwent placement of SEMS between 2012 and 2017 in two hospitals. Chemotherapy and BV-containing regimens, stent-related complications and outcomes were recorded.
Results
58 (42.6%) SEMS were placed as a bridge to surgery and 78 (57.4%) as a palliative intent for stage IV disease. 129 patients (94.9%) had a left-sided obstruction. Technical success was achieved in 133 of 136 (98%). Overall, major stent-related complications after two-weeks of insertion were observed in 36 patients (26.5%): Re-obstruction in 18 patients (50%), 11 perforations (30.5%), 5 bleeding (14%) and 2 migrations (5.5%). Complications in the metastatic group (n = 78) 14 (18%) had re-obstructions, 7 (9%) perforations, 4 (5%) minor bleeding and 2 (2.5%) migrations. Multivariate analysis identified stage IV and chemotherapy as significant risk factors for stent-related complications. Patients who received systemic therapy are more likely to develop complications (OR 1.84; CI95% 1.29-6.22, p = 0.0007). 16 patients received BV, 2 (12.5%) had a perforation. Univariate analysis did not show that BV was more likely to develop perforations, although the incidence was higher in this subset of patients. No differences were observed between chemotherapy alone and BV in overall complications. Kaplan-Meier analysis showed significant longer OS for patients treated with systemic therapy (27 vs. 11 months, p = <0.00001). There is a significant benefit of BV compared to chemotherapy alone (43 vs. 39 months, p = 0.02).
Conclusions
Placement of SEMS is effective and relatively safe but, with an overall complication rate of 26%. The major early risk is perforation that can increase up to 12% during BV treatment. In patients with obstructing advanced colorectal cancer that would benefit from SEMS, we should consider the risks associated with systemic therapies, taking into account the improvement in survival with BV.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2376 - Patient Reported Outcomes (PRO) in patients (pts) with HER2- advanced breast cancer (ABC) and a germline BRCA1/2 mutation (gBRCAm) receiving talazoparib (TALA) vs physician’s choice chemotherapy (PCT) in the EMBRACA trial: A focus on subgroups with/ without visceral disease
Presenter: Johannes Ettl
Session: Poster Display session 2
Resources:
Abstract
4874 - Complete Responses in Patients With 2nd-Line or Greater Metastatic Triple-Negative Breast Cancer (TNBC) Following First-in-Human Immunotherapy Combining NK and T Cell Activation with Off-the-Shelf High-Affinity CD16 NK Cell Line (haNK)
Presenter: Chaitali Nangia
Session: Poster Display session 2
Resources:
Abstract
4362 - Reproducibility and concordance of 4 clinically developed programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) assays in triple-negative breast cancer (TNBC)
Presenter: Aurelia Noske
Session: Poster Display session 2
Resources:
Abstract
4528 - Systemic Therapy in 2nd-Line Metastatic Triple Negative Breast Cancer (mTNBC): A Systematic Literature Review (SLR) and Meta-Analysis (MA) of Efficacy
Presenter: Peter Kaufman
Session: Poster Display session 2
Resources:
Abstract
4112 - Cisplatin given at three divided doses for three consecutive days in metastatic breast cancer: an alternative schedule for one full dose with comparable efficacy but less CINV and hypomagnesaemia
Presenter: Yang Chen
Session: Poster Display session 2
Resources:
Abstract
5699 - Patterns and predictors of first-line (1L) taxane use in US patients with metastatic triple-negative breast cancer (mTNBC)
Presenter: Joyce O’Shaughnessy
Session: Poster Display session 2
Resources:
Abstract
1931 - Maintenance Chemotherapy is effective in Patients with Metastatic Triple Negative Breast Cancer After First-line Platinum-based Chemotherapy
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract
4696 - Using the Patient-Reported Outcomes Measurement Information System (PROMIS) to investigate symptom burden enrichment in Stage IV patients at an academic center
Presenter: Madeline Matthys
Session: Poster Display session 2
Resources:
Abstract
4582 - Measures of functional status in adults aged ≥70 years with advanced breast cancer (ABC) receiving palbociclib (PAL) combination therapy in POLARIS
Presenter: Meghan Karuturi
Session: Poster Display session 2
Resources:
Abstract
3565 - Real-World 1-Year Survival Analysis of Patients with Metastatic Breast Cancer with Liver or Lung Metastasis Treated with Eribulin, Gemcitabine or Capecitabine
Presenter: Shayma Kazmi
Session: Poster Display session 2
Resources:
Abstract