Resection of the primary colorectal cancer is not necessary in nonobstructed patients with metastatic disease.
Asymptomatic patients with metastatic colorectal cancer do not routinely need to undergo resection of the primary tumor. Although several retrospective analyses suggest that patients who undergo resection of the primary tumor live longer, most of these reviewed data prior to the advent of modern polychemotherapy and are subject to considerable bias, as patients who were considered able to undergo surgery likely had better overall prognoses than those who were not. In addition to significant prolongation of overall survival, current combinations of systemic chemotherapeutic agents and targeted agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring colon resection.
Damjanov
Nevena
N
University of Pennsylvania, Abramson Cancer Center at Penn Presbyterian Medical Center, 51 North 39th Street, Philadelphia, PA 19104, USA. nevena.damjanov@uphs.upenn.edu
Weiss
Jared
J
Haller
Daniel G
DG
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D009362:Neoplasm Metastasis; D010166:Palliative Care; D018579:Patient Selection; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome