Does resection of primary lesions show survival benefit for stage IV colorectal cancer patients with unresectable metastases?
OBJECTIVE
The aims of the current retrospective cohort study were to compare OS of the primary resection (R-g) and the non-resection group (NR-g) after 2005.


METHODS
Ninety-five patients with stage IV colorectal cancer with unresectable distant metastases were divided into 2 groups; R-g; 37 and NR-g; 58.


RESULTS
The only significant difference in clinical factors between the 2 was R0 resection rate (p = 0.007). The MST in R-g was superior to that in NR-g, 30.7 vs. 21.9 months (p = 0.031). After excluding the patients that underwent R0 resection, there was no difference in OS between the 2; however, the MST was 28.6 months in R-g and 17.1 months in NR-g.


CONCLUSIONS
The advantage of resection of the primary is still unclear and a well-designed randomized Phase III study is expected. However, the current results suggest that resection of the primary lesion before intensive chemotherapy had some benefit for prognosis.
Yasushi
Y
Ichikawa
Ayumu
A
Goto
Noritoshi
N
Kobayashi
Mitsuyoshi
M
Ota
Motohiko
M
Tokuhisa
Atsushi
A
Ishibez
Jun
J
Watanabe
Kazuteru
K
Watanabe
Takashi
T
Ishikawa
Kuniya
K
Tanaka
Hirotoshi
H
Akiyama
Shoichi
S
Fujii
Itaru
I
Endo
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome