Primary tumor location as a predictor of the benefit of palliative resection for colorectal cancer with unresectable metastasisReport as inadecuate




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World Journal of Surgical Oncology

, 15:138

First Online: 27 July 2017Received: 28 October 2016Accepted: 03 July 2017

Abstract

BackgroundIt is still under debate that whether stage IV colorectal cancer patients with unresectable metastasis can benefit from primary tumor resection, especially for asymptomatic colorectal cancer patients. Retrospective studies have shown controversial results concerning the benefit from surgery. This retrospective study aims to evaluate whether the site of primary tumor is a predictor of palliative resection in asymptomatic stage IV colorectal cancer patients.

MethodsOne hundred ninety-four patients with unresectable metastatic colorectal cancer were selected from Sun Yat-sen University Cancer Center Database in the period between January 2007 and December 2013. All information was carefully reviewed and collected, including the treatment, age, sex, carcinoembryonic antigen, site of tumor, histology, cancer antigen 199, number of liver metastases, and largest diameter of liver metastasis. The univariate and multivariate analyses were used to detect the relationship between primary tumor resection and overall survival of unresectable stage IV colorectal cancer patients.

ResultsOne hundred twenty-five received palliative resection, and 69 received only chemotherapy. Multivariate analysis indicated that primary tumor site was one of the independent factors RR 0.569, P = 0.007 that influenced overall survival. For left-side colon cancer patients, primary tumor resection prolonged the median overall survival time for 8 months palliative resection vs. no palliative resection: 22 vs. 14 months, P = 0.009; however, for right-side colon cancer patients, palliative resection showed no benefit 12 vs. 10 months, P = 0.910.

ConclusionsThis study showed that left-side colon cancer patients might benefit from the primary tumor resection in terms of overall survival. This result should be further explored in a prospective study.

KeywordsColorectal cancer Unresectable liver metastases Primary tumor site AbbreviationsADAAdenocarcinoma

CACancer antigen

CEACarcinoembryonic antigen

CRCColorectal cancer

ECOGEastern Cooperative Oncology Group

FUFollow-up

LMLiver metastasis

LNsLymph nodes

LSCRCLeft-side colorectal cancer

LVILymphovascular invasion

mCRCMetastatic colorectal cancer

NCINational Cancer Institute

OSOverall survival

PNIPerineural invasion

RSCCRight-side colon cancer

SEERSurveillance, Epidemiology, and End Results Program

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Author: Rong-xin Zhang - Wen-juan Ma - Yu-ting Gu - Tian-qi Zhang - Zhi-mei Huang - Zhen-hai Lu - Yang-kui Gu

Source: https://link.springer.com/







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