CReST2

Colorectal cancer is the second most common cause of cancer death in the UK. Each year around 15% of people with colorectal cancer present with an obstruction. Patients are living longer with stents in situ, so choosing the right design of stent is important to maximise patients' quality of life. Two designs of stent are in common use in the UK today: covered and uncovered. Currently there is insufficient information to decide which of these two stent types is the best to use in people with colorectal cancer. CReST2 is designed to determine which stent design is the most efficacious in improving the quality of life in patients with bowel obstruction arising from colorectal cancer.

CReST2 was a 5 year, multi-centre randomised controlled trial. We aimed to recruit 350 patients over five years. Patients will be randomised to received either a covered or uncovered endoluminal stent. 

The primary objectives of the CReST2 trial are to determine:

1. If the Quality of Life for palliative colorectal cancer patients requiring a stent is dependent on whether the stent is covered or uncovered
2. If the efficacy of the stent is dependent on whether the stent is covered or uncovered. 

The secondary objectives are to determine:

1. If the technical success rates are different between covered and uncovered stents
2. If the incidence of stent-related complications (perforation, blockage, migration) are different between covered and uncovered stents
3. The rate of endoscopic re-interventions in each arm
4. Whether the stent type used affects the stoma rate
5. If the stent type used impacts on overall survival
6. The cost effectiveness of implementing covered stents compared to uncovered stents