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. 2025 Dec;41(6):528-536.
doi: 10.3393/ac.2025.00535.0076. Epub 2025 Dec 29.

Palliative resection versus palliative stenting for intestinal obstruction in patients with metastatic left-sided colonic cancer: a propensity score-matched analysis

Ruby Siu Ting Lau  1   2 , Sophie Sok Fei Hon  2 , Man Fung Ho  2 , Simon Chu  2 , Dennis Ck Ng  1 , Simon Sm Ng  3
Affiliations

Palliative resection versus palliative stenting for intestinal obstruction in patients with metastatic left-sided colonic cancer: a propensity score-matched analysis

Ruby Siu Ting Lau et al. Ann Coloproctol. 2025 Dec.

Abstract

Purpose: Palliative resection and palliative stenting are established options for managing obstruction in patients with metastatic left-sided colonic cancer. This retrospective study investigated the long-term outcomes and survival associated with each treatment modality.

Methods: Patients with left-sided colon cancer complicated by intestinal obstruction and unresectable metastatic lesions were included. Propensity score matching was conducted to balance demographic characteristics. The primary outcome was long-term survival. Secondary outcomes included short-term morbidity, length of hospital stay, clinical success rate, stoma formation rate, and number of readmissions due to tumor-related complications.

Results: Initially, 131 patients who underwent palliative resection or stenting between 2015 and 2022 were included. After propensity score matching, 98 patients remained (49 in each group). Survival was significantly better among patients receiving palliative resection compared to stenting (median, 19.6 months vs. 9.6 months; P=0.003). However, subgroup analysis for patients older than 70 years demonstrated no statistically significant survival benefit (median, 11.5 months vs. 10.2 months; P=0.240). The resection group experienced significantly higher rates of stoma formation and longer postoperative hospital stays. Readmission rates were similar. Cox regression analysis identified low carcinoembryonic antigen levels, tumor resection, chemotherapy, and targeted therapy as independent predictors of longer survival.

Conclusion: For metastatic colon cancer patients presenting with intestinal obstruction, palliative resection may offer a survival advantage. However, this benefit diminishes in patients over 70 years of age. Additionally, resection is associated with a higher rate of stoma formation. Therefore, individualized treatment decisions are warranted when choosing between palliative resection and palliative stenting in metastatic colonic cancer patients.

Keywords: Colectomy; Colon neoplasms; Secondary; Self expandable metallic stents.

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Conflict of interest statement

Conflict of interest

Simon SM Ng is an editorial board member of this journal, but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Survival analysis for patients of all ages.
Fig. 2.
Fig. 2.
Survival analysis for patients aged 70 or above.
See this image and copyright information in PMC

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