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Clinical significance of primary tumor resection in colorectal cancer patients with synchronous unresectable metastasis

Authors
Kim M.S.Chung M.Ahn J.B.Kim C.W.Cho M.S.Shin S.J.Baek S.J.Hur H.Min B.S.Baik S.H.Kim N.K.
Issue Date
2014
Publisher
John Wiley and Sons Inc.
Keywords
chemotherapy; colorectal neoplasm; primary tumor resection; synchronous unresectable metastasis
Citation
Journal of Surgical Oncology, v.110, no.2, pp.214 - 221
Indexed
SCIE
SCOPUS
Journal Title
Journal of Surgical Oncology
Volume
110
Number
2
Start Page
214
End Page
221
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/9963
DOI
10.1002/jso.23607
ISSN
0022-4790
Abstract
Background The aim of this study was to compare the outcomes in colorectal cancer (CRC) patients with synchronous unresectable metastases who received either primary tumor resection (PTR) or chemotherapy as the first treatment and to investigate the clinical course of asymptomatic patients who received chemotherapy as the first treatment. Methods We retrospectively analyzed 324 CRC patients with synchronous unresectable metastases. Overall survival (OS) was analyzed for the two groups (upfront PTR group [n = 72] vs. upfront chemotherapy group [n = 252]). Surgical morbidity and mortality were recorded. In the asymptomatic patients who received upfront chemotherapy, the incidences of primary tumor-related complications were analyzed. Results In patients who underwent PTR as the first treatment, the median OS period was superior to those who received upfront chemotherapy (17.2 vs. 13.6 months, P = 0.002). In the PTR group, surgical morbidity and mortality were 11.6% and 1.9%, respectively. Of the 252 asymptomatic patients, the incidence of primary tumor-related complications was 35%. Emergent surgery was ultimately done in 14% of the 252 patients. Conclusion CRC patients with synchronous unresectable metastases who underwent PTR followed by chemotherapy had significantly longer survival times compared to patients who received chemotherapy as the first treatment. © 2014 Wiley Periodicals, Inc.
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Baek, Se Jin
안암병원 (Department of Colon and Rectal Surgery, Anam Hospital)
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