Lorenzo Fuccio1, Loredana Correale2, Alberto Arezzo3, Alessandro Repici4, Gianpiero Manes5, Cristina Trovato6, Benedetto Mangiavillano7, Mauro Manno8, Claudio Camillo Cortelezzi9, Marco Dinelli10, Vincenzo Cennamo11, Mario de Bellis12. 1. Gastroenterology Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: lorenzofuccio@gmail.com. 2. Im3D Medical Imaging Lab, Turin, Italy. 3. Department of Surgical Sciences, University of Turin, Turin, Italy. 4. Digestive Endoscopy Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy. 5. Department of Gastroenterology, University Hospital L. Sacco, Milan, Italy. 6. Endoscopy Division, European Institute of Oncology, Milan, Italy. 7. Gastrointestinal Endoscopy Unit, Azienda Ospedaliera San Paolo, University of Milan, Milan, Italy. 8. Gastroenterology and Endoscopy Unit, New S. Agostino Hospital, Modena, Italy. 9. Division of Gastroenterology, Varese, Italy. 10. Department of Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy. 11. Unit of Digestive Endoscopy, Department of Surgery, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy. 12. Endoscopy Unit, National Cancer Institute and G. Pascale Foundation, Naples, Italy.
Abstract
BACKGROUND: This study aimed to explore the relationship between K-ras status, anti-tumour treatments, and the complications of colorectal self-expandable metallic stenting in colorectal cancer. METHODS: This is a retrospective, multicentre study of 91 patients with obstructive advanced colorectal cancer palliated with enteral stents between 2007 and 2011. RESULTS: K-ras wild-type tumours were diagnosed in 44 patients (48.4%); 82 (90.1%) received chemotherapy and 45 (49.4%) had additional biological therapy (34 bevacizumab, 11 cetuximab). Twenty-one (23.1%) experienced stent-related complications: 11 (52.4%) occurred in the K-ras mutant group (P=0.9). K-ras wild-type patients were not less likely to develop adverse events than K-ras mutant patients (OR, 0.99; 95% CI: 0.4-2.7). Overall mean time to complication was 167.6 days (range 4-720 days), with no difference between the two groups (141 vs. 197 days; P=0.5). Chemotherapy did not influence the risk of complications (OR, 0.56; 95% CI: 0.14-2.9), and there was no evidence that patients treated with chemotherapy and cetuximab were more likely to experience stent-related complications than patients treated with chemotherapy alone, or untreated (OR, 1.2; 95% CI: 0.2-5.9). Although perforation rates were higher with bevacizumab-based treatment (11.8% vs. 7%), this result was not statistically significant (P=0.69). CONCLUSIONS: K-ras mutation status, chemotherapy, and biological treatments should not influence colorectal stent-related complication rates.
BACKGROUND: This study aimed to explore the relationship between K-ras status, anti-tumour treatments, and the complications of colorectal self-expandable metallic stenting in colorectal cancer. METHODS: This is a retrospective, multicentre study of 91 patients with obstructive advanced colorectal cancer palliated with enteral stents between 2007 and 2011. RESULTS:K-ras wild-type tumours were diagnosed in 44 patients (48.4%); 82 (90.1%) received chemotherapy and 45 (49.4%) had additional biological therapy (34 bevacizumab, 11 cetuximab). Twenty-one (23.1%) experienced stent-related complications: 11 (52.4%) occurred in the K-ras mutant group (P=0.9). K-ras wild-type patients were not less likely to develop adverse events than K-ras mutant patients (OR, 0.99; 95% CI: 0.4-2.7). Overall mean time to complication was 167.6 days (range 4-720 days), with no difference between the two groups (141 vs. 197 days; P=0.5). Chemotherapy did not influence the risk of complications (OR, 0.56; 95% CI: 0.14-2.9), and there was no evidence that patients treated with chemotherapy and cetuximab were more likely to experience stent-related complications than patients treated with chemotherapy alone, or untreated (OR, 1.2; 95% CI: 0.2-5.9). Although perforation rates were higher with bevacizumab-based treatment (11.8% vs. 7%), this result was not statistically significant (P=0.69). CONCLUSIONS:K-ras mutation status, chemotherapy, and biological treatments should not influence colorectal stent-related complication rates.
Authors: Andrew S Miller; Kathryn Boyce; Benjamin Box; Matthew D Clarke; Sarah E Duff; Niamh M Foley; Richard J Guy; Lisa H Massey; George Ramsay; Dominic A J Slade; James A Stephenson; Phil J Tozer; Danette Wright Journal: Colorectal Dis Date: 2021-02 Impact factor: 3.917
Authors: Anouk E J Latenstein; Mathijs P Hendriks; Emo E van Halsema; Jeanin E van Hooft; Anne-Marie van Berkel Journal: Case Rep Gastroenterol Date: 2017-11-29