title: Influence of primary tumor resection on survival in asymptomatic patients with incurable stage IV colorectal cancer.
abstract: BACKGROUND
  The influence of resection of the primary lesion on the prognosis of patients with incurable stage IV colorectal cancer is unclear.
  
  
  METHODS
  We retrospectively analyzed 158 asymptomatic patients with incurable stage IV colorectal cancer who received systemic chemotherapy in our center from 2002 to 2009, either without (chemotherapy group; n = 112) or after (resection group; n = 46) primary tumor resection. Primary tumor resection was performed if the fiberscope did not pass through the primary lesion. Survival was compared between the 2 groups, and the actual surgical intervention was assessed.
  
  
  RESULTS
  At a median follow-up period of 26 months (range 7-91 months), the median survival times were 19.9 months in the resection group and 19.0 months in the chemotherapy group (HR = 0.81, 95 % CI 0.53-1.19, p = 0.29). Among the tumor resection group, 8 (17 %) experienced postoperative complications, with all showing improvement after conservative treatment. In the chemotherapy group, 18 patients (21 %) required surgical interventions for symptoms associated with progression of the primary tumor.
  
  
  CONCLUSIONS
  Resection of the primary tumor in asymptomatic patients with incurable stage IV colorectal cancer was safe, but had no effect on prognosis.
authors: Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-877, Japan.
authors: Akira
authors: A
authors: Watanabe
authors: Kentaro
authors: K
authors: Yamazaki
authors: Yusuke
authors: Y
authors: Kinugasa
authors: Shunsuke
authors: S
authors: Tsukamoto
authors: Tomohiro
authors: T
authors: Yamaguchi
authors: Akio
authors: A
authors: Shiomi
authors: Takahiro
authors: T
authors: Tsushima
authors: Tomoya
authors: T
authors: Yokota
authors: Akiko
authors: A
authors: Todaka
authors: Nozomu
authors: N
authors: Machida
authors: Akira
authors: A
authors: Fukutomi
authors: Yusuke
authors: Y
authors: Onozawa
authors: Hirofumi
authors: H
authors: Yasui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies