{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:22:14Z","timestamp":1783430534550,"version":"3.54.6"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research (NIHR) Health Technology Program","doi-asserted-by":"publisher","award":["14\/28\/02"],"award-info":[{"award-number":["14\/28\/02"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Around 15% of people with colon cancer present with an obstruction. Stenting is appropriate for patients unfit for surgery and\/or those with advanced cancer. Patients are living longer with advanced colon cancer; stent design (covered versus uncovered) may influence stent re-intervention and quality of life (QoL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>CReST2 is a phase III multicentre RCT. Patients were randomized 1 : 1 to receive either a covered or uncovered stent. Patients and all medical personnel except the person placing the stent were blinded to allocation. Treatment allocation was via a central randomization service, minimized for: age (\u226470 years, &amp;gt;70 years), WHO performance status, tumour site, and indication for palliation. Co-primary endpoints were stent patency up to 6 months after randomization and QoL at 3 months (30 days for patients who died before 3 months) from randomization measured using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 global health score. Secondary endpoints were stenting success rate, rates of short-term (30 days), intermediate-term (1\u20133 months), and long-term (3\u20136 months) stent-related complications, stent-related complication rates of patients undergoing chemotherapy within 6 months after randomization, cumulative frequency of stoma formation, survival at 6 months, and overall survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 377 patients were randomised across 28 sites, in whom stenting was unsuccessful in 47 (12.5%) patients (27 of 188: 14.4% covered and 20 of 186: 10.7% uncovered stents). Stent patency at 6 months in stented patients was 117 of 161 (72.7%, covered) and 136 of 166 (81.9%, uncovered) (adjusted HR 1.48, 97.5% confidence interval (c.i.): 0.86\u20132.54). In this stented population, 216 patients (66.1%) contributed to QoL assessment at 3 months with mean(s.d.) QLQ-C30 global health scores of 54.1(23.9) and 51.6(25.4) in the covered and uncovered groups respectively (adjusted mean difference 1.63, 97.5% c.i. \u20135.85\u20139.11). The total numbers of patients experiencing at least one complication in the first 6 months after randomization were 42 of 161 (26.1%) for covered stents and 29 of 166 (17.5%) for uncovered stents. Stent migration was the most common complication and was higher in the covered group. In the covered group and the uncovered group, 44 of 161 (27.3%) and 40 of 166 (24.1%) patients respectively received chemotherapy up to 6 months after randomization. There was a low risk of late perforation associated with both types of stent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There appears to be greater prolonged stent patency and less stent failure with uncovered stents. QoL is unaffected by stent design.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration number<\/jats:title>\n                  <jats:p>ISRCTN54834267.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf117","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T07:56:20Z","timestamp":1750233380000},"source":"Crossref","is-referenced-by-count":2,"title":["Covered <i>versus<\/i> uncovered endoluminal stenting in the acute management of obstructing colorectal cancer in the palliative setting: randomized clinical trial (CReST2)"],"prefix":"10.1093","volume":"112","author":[{"name":"CReST2 Collaborative 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