title: The beneficial effect of palliative resection in metastatic colorectal cancer.
abstract: BACKGROUND
  We aimed to determine the role of palliative resection in metastatic colorectal cancer (mCRC) and ascertain which patient populations would benefit most from this treatment.
  
  
  METHODS
  A total of 1015 patients diagnosed with mCRC at Seoul National University Hospital between 2000 and 2009 were retrospectively studied.
  
  
  RESULTS
  Of the 1015 patients, 168 patients with only liver and/or lung metastasis received curative resection. The remaining 847 patients were treated with palliative chemotherapy and/or palliative resection combined with best supportive care. Palliative resection was performed in 527 (62.2%) cases (complete resection with negative margin (R0) in 93, R1/2 in 434). Resected patients had a more prolonged median overall survival (OS) than unresected patients (21.3 vs 14.1 months; P<0.001). In multivariate analysis, R0 resection was found to be associated with a superior OS compared with R1/2 resection (51.3 vs 19.1 months; P<0.001) and no resection (51.3 vs 14.1 months; P<0.001). When we performed propensity score matching, palliative resection was found to be related to prolonged OS (hazard ratio=0.72, 95% confidence interval=0.59-0.89; P=0.003).
  
  
  CONCLUSIONS
  Palliative resection without residual disease and chemotherapy confers a longer-term survival outcome than palliative chemotherapy alone in mCRC patient subset.
authors.affiliation: Division of Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, 101 Daehang-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Park
authors.forename: T-Y
authors.initials: TY
authors.lastname: Kim
authors.forename: K-H
authors.initials: KH
authors.lastname: Lee
authors.forename: S-W
authors.initials: SW
authors.lastname: Han
authors.forename: D-Y
authors.initials: DY
authors.lastname: Oh
authors.forename: S-A
authors.initials: SA
authors.lastname: Im
authors.forename: G H
authors.initials: GH
authors.lastname: Kang
authors.forename: E K
authors.initials: EK
authors.lastname: Chie
authors.forename: S W
authors.initials: SW
authors.lastname: Ha
authors.forename: S-Y
authors.initials: SY
authors.lastname: Jeong
authors.forename: K J
authors.initials: KJ
authors.lastname: Park
authors.forename: J-G
authors.initials: JG
authors.lastname: Park
authors.forename: T-Y
authors.initials: TY
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult