Complications from the primary tumour are not related with survival in patients with synchronous stage IV colorectal cancer receiving chemotherapy without primary tumour resection

Abstract

Twenty percent of patients will suffer a CPT during chemotherapy treatment. The inability to pass the tumour with an endoscope can predict the CPT. Survival was only related to the addition of target therapies to chemotherapy.

The impact of bevacizumab in metastatic colorectal cancer with an intact primary tumor: Results from a large prospective cohort study

“…When patients were grouped based on whether or not they experienced bevacizumab‐related adverse events, we found no significant difference in median survival between the adverse events and no adverse events groups (20.0 months vs 19.9 months, HR = 0.98, P = 0.623). These results concur with those of smaller studies by Poultsides et al and Suarez et al …”

Stent placement prior to initiation of chemotherapy in patients with obstructive, nonoperative left sided tumors is associated with fewer stomas

“…Nevertheless, about 20‐30% of patients will suffer a complication from the primary tumor during chemotherapy treatment, colorectal obstruction being the most common . In these cases, the inability to pass through the tumor with an endoscope (appears obstructive, but is not symptomatic at the time) is correlated with the subsequent onset of complications 36.5‐64.3% of the time …”

“…12,13 In these cases, the inability to pass through the tumor with an endoscope (appears obstructive, but is not symptomatic at the time) is correlated with the subsequent onset of complications 36.5-64.3% of the time. 3,4 In (Table 6). One possible explanation is that starting chemotherapy prior to stent placement might increase the risk of subsequent perforation.…”

“…In these patients, emergent surgery is associated with a mortality and morbidity up to 10.5% and 38%, respectively . The presence of an endoscopically non‐transversable tumor is a risk factor for the development of complications …”

“…2 The presence of an endoscopically non-transversable tumor is a risk factor for the development of complications. 3,4 However, due to the potential risks associated with placing colonic self-expanding metallic stent (SEMS), European Society Gastrointestinal Endoscopy does not recommend prophylactic insertion of SEMS prior to ChT in patients without symptoms, their placement currently indicated only in symptomatic tumors. 5 We confront patients with minimal symptoms and upfront ChT as first treatment (ChT group) with patients in which a SEMS was placement prior to ChT administration (SEMS group).…”