title: Treatment strategy for rectal cancer with synchronous metastasis: 65 consecutive Italian cases from the Bologna Multidisciplinary Rectal Cancer Group.
abstract: BACKGROUND
  Twenty percent of rectal cancer patients have synchronous distant metastasis at diagnosis. At present, the treatment strategy in this patient setting is not well defined. This study in one institution evaluates the treatment strategy of three different patient groups.
  
  
  METHODS
  Between January 2000 and July 2011, 65 patients with M1 rectal cancer were evaluated. Three different groups were defined: rectal cancer with resectable metastatic disease (group A); rectal cancer with potentially resectable metastatic disease (group B), and rectal cancer with unresectable metastatic disease (group C).
  
  
  RESULTS
  Group A included 11 patients (16.9%), group B 28 patients (43.1%) and group C 26 patients (40%). Forty-three (66.2%) patients underwent surgery for primary rectal cancer, and 30 (46.2%) patients for metastasis resection (23 liver, 4 lung and 3 ovary). Median overall survival (OS) by group was: 51 (5-86; group A), 32 (24-40; group B) and 16 (7-26; group C) months. Patients undergoing metastasis resection have higher median OS than unresected patients (44 vs. 15 months; p < 0.001).
  
  
  CONCLUSIONS
  The treatment strategy in synchronous metastatic rectal cancer must consider the possibility of distant metastasis resection. Long-term survival can be achieved using an integrated approach.
authors: Unit of Medical Oncology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors: Carmine
authors: C
authors: Pinto
authors: Sara
authors: S
authors: Pini
authors: Francesca
authors: F
authors: Di Fabio
authors: Dajana
authors: D
authors: Cuicchi
authors: Bruno
authors: B
authors: Iacopino
authors: Ferdinando
authors: F
authors: Lecce
authors: Giorgio
authors: G
authors: Ercolani
authors: Fabiola Lorena
authors: FL
authors: Rojas Llimpe
authors: Emilio
authors: E
authors: De Raffele
authors: Franco
authors: F
authors: Stella
authors: PierGiorgio
authors: P
authors: Di Tullio
authors: Stefania
authors: S
authors: Giaquinta
authors: Antonio Daniele
authors: AD
authors: Pinna
authors: Bruno
authors: B
authors: Cola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D007558:Italy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome