title: [Clinical analysis of patients with stage IV ( colorectal cancer after palliative resection of primary tumor].
abstract: OBJECTIVE
  To investigate the independent predictors of postoperative mortality, morbidity, and long-term survival in patients with stage IV ( colorectal cancer.
  
  
  METHODS
  Clinical data of 189 patients with stage IV( colorectal cancer undergoing palliative resection of primary tumor in the presence of unresectable synchronous metastases were analyzed retrospectively.
  
  
  RESULTS
  Eighty-six (45.5%)patients developed postoperative complications. Preoperative predictors of medical complications included age(≥65, P=0.039) and emergency operations (P=0.001). Preoperative predictors of surgical complications included advanced local disease (T4, P=0.022) and lymph node spread (N2, P=0.009). Seventeen (9.0%) patients died in the postoperative period. Mortality was independently associated with age(P=0.013), peritoneal dissemination(P=0.010), emergency operations(P=0.001) and medical complications(P=0.008). The survival rates at 1-, 2-, and 3- year of 172 patients admitted in survival analysis were 41.2%, 22.7% and 7.7% respectively. Independent factors associated with poor overall survival included lymph node spread(N2, P=0.015) and poor tumor differentiation(P=0.038).
  
  
  CONCLUSIONS
  Emergency operations should be avoid when palliative resection of primary tumor is considered for stage IV( colorectal cancer patients, especially for elderly patients and those with peritoneal dissemination. The significance of palliative resection is limited for stage IV ( colorectal cancer patients with lymph node spread and poor tumor differentiation.
authors.affiliation: Department of General Surgery, The First People's Hospital of Chun'an, Zhejiang Chun'an, China. zhanxiaoping8181@126.com
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Zhan
authors.forename: Jing-tao
authors.initials: JT
authors.lastname: Shao
authors.forename: Ding
authors.initials: D
authors.lastname: Li
authors.forename: De-guang
authors.initials: DG
authors.lastname: Pan
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes; D009367:Neoplasm Staging; D010166:Palliative Care; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis