Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study
Self-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristi...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2016/1945172 |
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| author | Anna M. Borowiec Charlie S. K. Wang Elaine Yong Calvin Law Natalie Coburn Rinku Sutradhar Nancy Baxter Lawrence Paszat Jill Tinmouth |
| author_facet | Anna M. Borowiec Charlie S. K. Wang Elaine Yong Calvin Law Natalie Coburn Rinku Sutradhar Nancy Baxter Lawrence Paszat Jill Tinmouth |
| author_sort | Anna M. Borowiec |
| collection | DOAJ |
| description | Self-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristics, poststent insertion health outcomes, and health care encounters were recorded. 225 patients were identified over the study period. Median age was 69 years, 2/3 were male, and 2/3 had metastatic disease. Stent use for CRC increased over the study period and gastroenterologists inserted most stents. The median survival after stent insertion was 199 (IQR, 69–834) days. 37% of patients required an additional procedure. Patients with metastatic disease were less likely to go on to surgery (HR 0.14, 95% CI 0.06–0.32, p<0.0001). There were 2.4/person-year emergency department visits (95% CI 2.2–2.7) and 2.3 hospital admissions/person-year (95% CI 2.1–2.5) following stent insertion. Most admissions were cancer or procedure related or for palliation. Factors associated with hospital admissions were presence of metastatic disease, lack of chemotherapy treatment, and stoma surgery. Overall the use of stents for CRC obstruction remains low. Stents are predominantly used for palliation with low rates of postinsertion health care encounters. |
| format | Article |
| id | doaj-art-ccfbe13ea4124650b721c33f9168d855 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-ccfbe13ea4124650b721c33f9168d8552025-02-03T05:45:36ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972016-01-01201610.1155/2016/19451721945172Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based StudyAnna M. Borowiec0Charlie S. K. Wang1Elaine Yong2Calvin Law3Natalie Coburn4Rinku Sutradhar5Nancy Baxter6Lawrence Paszat7Jill Tinmouth8Department of Surgery, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Surgery, University of Toronto, Toronto, ON, CanadaDepartment of Surgery, University of Toronto, Toronto, ON, CanadaDepartment of Surgery, University of Toronto, Toronto, ON, CanadaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaDepartment of Surgery, University of Toronto, Toronto, ON, CanadaDepartment of Radiation Oncology, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaSelf-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristics, poststent insertion health outcomes, and health care encounters were recorded. 225 patients were identified over the study period. Median age was 69 years, 2/3 were male, and 2/3 had metastatic disease. Stent use for CRC increased over the study period and gastroenterologists inserted most stents. The median survival after stent insertion was 199 (IQR, 69–834) days. 37% of patients required an additional procedure. Patients with metastatic disease were less likely to go on to surgery (HR 0.14, 95% CI 0.06–0.32, p<0.0001). There were 2.4/person-year emergency department visits (95% CI 2.2–2.7) and 2.3 hospital admissions/person-year (95% CI 2.1–2.5) following stent insertion. Most admissions were cancer or procedure related or for palliation. Factors associated with hospital admissions were presence of metastatic disease, lack of chemotherapy treatment, and stoma surgery. Overall the use of stents for CRC obstruction remains low. Stents are predominantly used for palliation with low rates of postinsertion health care encounters.http://dx.doi.org/10.1155/2016/1945172 |
| spellingShingle | Anna M. Borowiec Charlie S. K. Wang Elaine Yong Calvin Law Natalie Coburn Rinku Sutradhar Nancy Baxter Lawrence Paszat Jill Tinmouth Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study Canadian Journal of Gastroenterology and Hepatology |
| title | Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study |
| title_full | Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study |
| title_fullStr | Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study |
| title_full_unstemmed | Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study |
| title_short | Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study |
| title_sort | colonic stents for colorectal cancer are seldom used and mainly for palliation of obstruction a population based study |
| url | http://dx.doi.org/10.1155/2016/1945172 |
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