title: [Treatment of colorectal cancer with unresectable metastasis with chemotherapy without primary tumor resection: analysis of tumor-related complications].
abstract: BACKGROUND
  Although the conventional treatment of patients with stage iv colorectal cancer involves resection of the primary tumor followed by chemotherapy, several studies suggest that in patients with few symptoms the first and only treatment should be chemotherapy. The objective of this study is to analyze the complications related to the primary tumor in a series of patients with unresectable metastatic colorectal cancer treated with chemotherapy without surgery.
  
  
  METHODS
  Retrospective descriptive study. The study included all patients with unresectable metastatic colorectal cancer treated with chemotherapy without resection of the primary tumor (January 2007-February 2011).
  
  
  RESULTS
  The mean age of the 61 patients analyzed was 67±13 years and the performance status was 0-1 in 53 (87%). Twenty (33%) patients developed complications during follow-up. The most common complication was intestinal obstruction in 15 (25%) patients followed by perforation. Complications required surgery in 6 (10%) cases. We did not find differences in patient characteristics between those who had a complication and those without, although the complication rate in patients with a colonic stent (53%) was twice that of other patients (26%).
  
  
  CONCLUSIONS
  Chemotherapy without surgery is a good option in most patients with unresectable metastatic colorectal cancer. However, although the percentage of patients requiring surgery is low, the total number of complications related to the primary tumor is not negligible. Studies are needed to identify those patients in whom a prophylactic colectomy could be indicated.
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Cáceres
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Pascual
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Sandra
authors.initials: S
authors.lastname: Alonso
authors.affiliation: Servicio de Oncología, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Clara
authors.initials: C
authors.lastname: Montagut
authors.affiliation: Servicio de Oncología, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Manel
authors.initials: M
authors.lastname: Gallén
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España.
authors.forename: Ricard
authors.initials: R
authors.lastname: Courtier
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España.
authors.forename: M José
authors.initials: MJ
authors.lastname: Gil
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
authors.affiliation: Servicio de Digestivo, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Andreu
authors.affiliation: Unidad de Cirugía Colorrectal, Unidad Funcional de Cáncer Colorrectal, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España. Electronic address: mpera@parcdesalutmar.cat.
authors.forename: Miguel
authors.initials: M
authors.lastname: Pera
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D012189:Retrospective Studies
keywords: Chemotherapy; Cirugía paliativa; Colorectal cancer; Cáncer colorrectal; Metástasis irresecables; Palliative surgery; Quimioterapia; Unresectable metastases