ArticleBritish journal of cancer2026
Neoadjuvant chemotherapy as a bridge to surgery versus direct surgery following SEMS placement in obstructive left-sided colon cancer: a multicenter prospective cohort study.
Article in British journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
objectiveTo investigate the perioperative complications and long-term outcomes of self-expanding metallic stent (SEMS) placement combined with neoadjuvant chemotherapy followed by elective surgery in patients with complete obstructive left-sided colon cancer (COLCC).
methodsA multicenter prospective study enrolled 246 COLCC patients, comparing SEMS-surgery (n = 105) and SEMS-neoadjuvant-surgery (n = 141). 1:1 propensity score matching (PSM) and 8-week landmark analyses were used to mitigate biases. Primary outcomes included SEMS-related complications, overall survival (OS), and disease-free survival (DFS).
resultsIn the PSM cohort (n = 206), SEMS-related complication rates were similar between the neoadjuvant and surgery-alone groups (15.5% vs. 14.6%, P = 0.845). The SEMS-neoadjuvant-surgery group demonstrated superior 5-year OS (66.2% vs. 51.7%, P < 0.001) and 5-year DFS (65.3% vs. 40.0%, P < 0.001). Landmark analysis consistently validated these survival benefits. Multivariable Cox regression confirmed neoadjuvant chemotherapy as an independent protective factor for both OS (HR = 0.436, 95% CI: 0.188-0.996, P = 0.015) and DFS (HR = 0.661, 95% CI: 0.551-0.830, P = 0.002).
conclusionThe SEMS-neoadjuvant-surgery strategy is associated with superior long-term survival without increasing SEMS-related complications, strongly supporting its clinical feasibility and oncological safety for COLCC.
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