title: Risk factors for the requirement of surgical or endoscopic interventions during chemotherapy in patients with uncomplicated colorectal cancer and unresectable synchronous metastases.
abstract: OBJECTIVE
  The purpose of this study was to determine the risk factors for requirement of surgical or endoscopic interventions for complications caused by the primary tumor during chemotherapy in patients with unresectable metastatic colorectal cancer.
  
  
  METHODS
  A total of 259 patients were diagnosed with uncomplicated colorectal cancer with unresectable metastatic disease and underwent chemotherapy as an initial treatment. Among them, 57 (22.0%) patients underwent palliative interventions because of complications caused by the primary tumor during chemotherapy, including bypass surgery or diverting enterostomy for 22 patients, insertion of colonic stent for 22, and resection of primary tumor for 13.
  
  
  RESULTS
  Multivariate analysis revealed that rectal lesion (RR, 2.132; 95% CI, 1.080-4.210; P = 0.029) and tumor size larger than 5 cm (RR = 3.644, 95% CI = 1.923-6.902; P < 0.001) were significant risk factors for requirement of palliative intervention. Patients who had none of the risk factors showed better overall survival than those who had one or more (P = 0.021).
  
  
  CONCLUSIONS
  Tumor location in rectum and tumor size larger than 5 cm were significant risk factors for the requirement of surgical or endoscopic interventions during chemotherapy for complications caused by the primary tumor in patients with unresectable metastatic colorectal cancer.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung-A
authors.initials: JA
authors.lastname: Yun
authors.forename: Yoonah
authors.initials: Y
authors.lastname: Park
authors.forename: Jung Wook
authors.initials: JW
authors.lastname: Huh
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Cho
authors.forename: Seong Hyeon
authors.initials: SH
authors.lastname: Yun
authors.forename: Hee Cheol
authors.initials: HC
authors.lastname: Kim
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Lee
authors.forename: Ho-Kyung
authors.initials: HK
authors.lastname: Chun
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
keywords: chemotherapy; colorectal cancer; complications of the primary tumor; palliative intervention; unresectable metastases