Elective palliative resection of incurable stage IV colorectal cancer: who really benefits from it?
OBJECTIVE
Despite the encouraging results of chemotherapy in patients affected by incurable colorectal cancer (CRC), surgical resection of a primitive tumor is still a common approach worldwide. The identification of prognostic factors related to short survival (<6 months) may allow excluding from resective surgery those who may not benefit from it.


METHODS
A retrospective analysis was performed of 15 variables in a population of 71 patients undergoing nonemergency palliative primary resections of incurable CRC, including patients' demographics and clinical/histopathological characteristics of the tumor.


RESULTS
No variables were related to perioperative mortality (8.5% overall). A multivariate analysis revealed that older age (≥80 years) and metastasis to more than 25% of the lymph nodes were associated with survival (4 and 6 months, respectively). Mucoid adenocarcinoma therefore tends to be associated with the prognosis (P = 0.070).


CONCLUSIONS
An elderly age tends to be a contraindication to an elective primary tumor resection in patients affected by incurable CRC. Massive lymph node involvement and mucoid adenocarcinoma should also be considered before planning major colonic surgery.
Dipartimento di Scienze Chirurgiche, Università di Parma, Via Gramsci 14, Parma, Italy.
Renato
R
Costi
Davide
D
Di Mauro
Licia
L
Veronesi
Andrea
A
Ardizzoni
Pierfranco
P
Salcuni
Luigi
L
Roncoroni
Leopoldo
L
Sarli
Vincenzo
V
Violi
D002288:Adenocarcinoma, Mucinous / Q000601:surgery; D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D010166:Palliative Care; D012189:Retrospective Studies
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