title: Intestinal complications after palliative treatment for asymptomatic patients with unresectable stage IV colorectal cancer.
abstract: BACKGROUND
  The initial surgical management of asymptomatic patients with unresectable stage IV colorectal cancer (CRC) is still controversy. The aim of this study was to compare the incidence of major intestinal complications in asymptomatic patients who received palliative treatment for unresectable stage IV CRC, according to the type of treatment.
  
  
  METHODS
  Between March 2001 and January 2008, we retrospectively analyzed 227 asymptomatic patients who underwent first-line resection of the primary tumor followed by chemotherapy (144 patients, resection group) or those who underwent first-line chemotherapy (83 patients, chemotherapy group).
  
  
  RESULTS
  In the resection group, the incidences of intestinal obstruction, peritonitis, fistula, and intestinal hemorrhage were 14.6%, 0%, 0.7%, and 4.8%, respectively. In the chemotherapy group, these incidences were 15.2%, 1.2%, 0%, and 3.5%, respectively. There were no significant differences between the two groups in terms of intestinal complications. In multivariate analysis of overall survival, treatment type (resection group vs. chemotherapy group) was not a significant prognostic factor (P = 0.076).
  
  
  CONCLUSIONS
  In asymptomatic patients with unresectable stage IV CRC, first-line chemotherapy may be considered safe, with no increased risk of major intestinal complications compared with primary tumor resection plus chemotherapy.
authors.affiliation: Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Guh Jung
authors.initials: GJ
authors.lastname: Seo
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Sang Bum
authors.initials: SB
authors.lastname: Yoo
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Hyo Seong
authors.initials: HS
authors.lastname: Choi
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Chang
authors.forename: Aesun
authors.initials: A
authors.lastname: Shin
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000209:etiology* / Q000473:pathology; D000077146:Irinotecan; D008297:Male; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010166:Palliative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D000077146:Irinotecan; D000068818:Cetuximab; D002166:Camptothecin