Colon or Rectal Stent Positioning for Advanced Cancer Influences Quality of Life: A Critical Point of View.


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 05 02 2021
revised: 01 03 2021
accepted: 02 03 2021
entrez: 4 4 2021
pubmed: 5 4 2021
medline: 28 4 2021
Statut: ppublish

Résumé

Endoluminal self-expanding metallic stents (SEMS) may overcome the risk of mortality and morbidity of acute intestinal obstruction because of stage IV colon (CC) or rectal (RC) cancer. We evaluated the QoL in these groups of patients. Forty-eight patients were enrolled in a prospective longitudinal cohort single-center trial to undergo SEMS positioning. Twenty-five patients had a CC and 23 RC. Karnofsky performance scale, Visual Analogue Scale and the EQ-5D- 5L™ questionnaire were administered before treatment and at 1, 3 and 6 months. Harmonized to the Italian population, the index values showed a statistically significant deterioration of the QoL in patients with RC when compared to those with CC at 1-, 3- and 6-months (1 month: p=0.001; 3- month: p=0.001; 6-month: p=0.045). Similarly, Visual Analogue Scale showed variations at 1- (p=0.008), 3- (p=0.001) and 6-months (p=0.020). Rectal stent deployment was the only independent predictor for a worse QoL in all domains (p<0.017; OR=0.196; 95%CI=0.51-0.749). Patients affected with stage IV CC had a better QoL after SEMS placement when compared to those affected with RC. The persistency of the primary tumor at the rectal level, even if irradiated, might negatively affect QoL.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Endoluminal self-expanding metallic stents (SEMS) may overcome the risk of mortality and morbidity of acute intestinal obstruction because of stage IV colon (CC) or rectal (RC) cancer. We evaluated the QoL in these groups of patients.
PATIENTS AND METHODS METHODS
Forty-eight patients were enrolled in a prospective longitudinal cohort single-center trial to undergo SEMS positioning. Twenty-five patients had a CC and 23 RC. Karnofsky performance scale, Visual Analogue Scale and the EQ-5D- 5L™ questionnaire were administered before treatment and at 1, 3 and 6 months.
RESULTS RESULTS
Harmonized to the Italian population, the index values showed a statistically significant deterioration of the QoL in patients with RC when compared to those with CC at 1-, 3- and 6-months (1 month: p=0.001; 3- month: p=0.001; 6-month: p=0.045). Similarly, Visual Analogue Scale showed variations at 1- (p=0.008), 3- (p=0.001) and 6-months (p=0.020). Rectal stent deployment was the only independent predictor for a worse QoL in all domains (p<0.017; OR=0.196; 95%CI=0.51-0.749).
CONCLUSION CONCLUSIONS
Patients affected with stage IV CC had a better QoL after SEMS placement when compared to those affected with RC. The persistency of the primary tumor at the rectal level, even if irradiated, might negatively affect QoL.

Identifiants

pubmed: 33813400
pii: 41/4/1945
doi: 10.21873/anticanres.14961
doi:

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1945-1950

Auteurs

Enrico Fiori (E)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Daniele Crocetti (D)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy; daniele.crocetti@uniroma1.it.

Paolo Sapienza (P)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Michelangelo Miccini (M)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Roberto Cirocchi (R)

Department of Surgical and Biomedical Sciences, Perugia University, Terni, Italy.

Antonio V Sterpetti (AV)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Francesca DE Felice (F)

Department of Radiology, Radiotherapy, Oncology and Pathology, "Sapienza" University of Rome, Rome, Italy.

Silvano Costi (S)

Department of Economics and Finance, LUISS Guido Carli, Rome, Italy.

Gioia Brachini (G)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Andrea Mingoli (A)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Antonietta Lamazza (A)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

Giorgio DE Toma (G)

Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy.

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