title: Palliative resection of a primary tumor in patients with unresectable colorectal cancer: could resection type improve survival?
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of extended resection of primary tumor on survival outcome in unresectable colorectal cancer (UCRC).
  
  
  METHODS
  A retrospective analysis was conducted for 190 patients undergoing palliative surgery for UCRC between 1998 and 2007 at a single institution. Variables including demographics, histopathological characteristics of tumors, surgical procedures, and course of the disease were examined.
  
  
  RESULTS
  Kaplan-Meier survival curve indicated a significant increase in survival times in patients undergoing extended resection of the primary tumor (P < 0.001). Multivariate analysis showed that extra-abdominal metastasis (P = 0.03), minimal resection of the primary tumor (P = 0.034), and the absence of multimodality adjuvant therapy (P < 0.001) were significantly associated poor survival outcome. The histological characteristics were significantly associated with survival times. Patients with well to moderate differentiation tumors that were extensively resected had significantly increased survival time (P < 0.001), while those with poor differentiation tumors that were extensively resected did not have increase survival time (P = 0.786).
  
  
  CONCLUSIONS
  Extended resection of primary tumors significantly improved overall survival compared to minimal resection, especially in well to moderately differentiated tumors (survival time: extended resection, 27.8 ± 2.80 months; minimal resection, 16.5 ± 2.19 months; P = 0.002).
authors.affiliation: Department of Surgery, Chonnam University Hospital, Gwangju, Korea.
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Jang
authors.affiliation: Department of Surgery, Chonnam University Hospital, Gwangju, Korea.
authors.forename: Jae Kyun
authors.initials: JK
authors.lastname: Ju
authors.affiliation: Department of Surgery, Chonnam University Hwasun Hospital, Gwangju, Korea.
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Chonnam University Hwasun Hospital, Gwangju, Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Surgery, Chonnam University Hwasun Hospital, Gwangju, Korea.
authors.forename: Hyeong Rok
authors.initials: HR
authors.lastname: Kim
authors.affiliation: Department of Surgery, Chonnam University Hwasun Hospital, Gwangju, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
keywords: Colorectal neoplasms; Colorectal surgery; Palliative care