First-Line Chemotherapy vs Bowel Tumor Resection Plus Chemotherapy for Patients With Unresectable Synchronous Colorectal Hepatic Metastases

Galizia, Gennaro; Lieto, Eva; Orditura, Michele; Castellano, Paolo; Imperatore, Vincenzo; Pinto, Margherita; Zamboli, Anna

doi:10.1001/archsurg.143.4.352

Cited by 114 publications

(163 citation statements)

References 27 publications

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…About 20-25% of patients with newly diagnosed CRC present with distant metastases (2)(3)(4), and only a small population of these patients can undergo curative operation (5). For patients with unresectable metastatic tumors, the standard treatment is systemic chemotherapy.…”

Section: The Measurement Of Tils In the Primary Tumor Using The Methomentioning

confidence: 99%

Tumor-infiltrating Lymphocytes Predict the Chemotherapeutic Outcomes in Patients with Stage IV Colorectal Cancer

Shibutani

Maeda

Nagahara

et al. 2018

View full text Add to dashboard Cite

Abstract. Background Colorectal cancer (CRC) is one of the most common causes of cancer-related death worldwide (1). About 20-25% of patients with newly diagnosed CRC present with distant metastases (2-4), and only a small population of these patients can undergo curative operation (5). For patients with unresectable metastatic tumors, the standard treatment is systemic chemotherapy. As mentioned in the ESMO clinical practice guidelines (4), an individualized approach to clinical decision-making should be adopted according to the patient's stratification. Therefore, numerous attempts have been made to identify useful prognostic markers for accurate patient stratification.Anticancer immunity is known to affect cancer progression (6). Tumor-infiltrating lymphocytes (TILs), which reflect the immune status of the host (7), have been reported to correlate with the clinical outcome, including the chemotherapeutic outcome in patients with various types of cancer (8-10). However, the method of measuring TILs has differed among previous reports (11)(12)(13)(14)(15). Recently, a new method of measuring TILs in breast cancer was proposed by the International TILs Working Group, using H-E-stained sections (16). In the current study, we applied this method to CRC.The aim of the present study was to evaluate the significance of the TILs in the primary tumor as a marker for predicting the chemotherapeutic outcome in patients with stage IV CRC using the method proposed by the International TILs Working Group. Patients and MethodsPatients. We retrospectively reviewed a database of 57 patients who underwent palliative combination chemotherapy for unresectable metastatic colorectal cancer after resection of the primary tumor at

show abstract

Section: The Measurement Of Tils In the Primary Tumor Using The Methomentioning

confidence: 99%

Tumor-infiltrating Lymphocytes Predict the Chemotherapeutic Outcomes in Patients with Stage IV Colorectal Cancer

Shibutani

Maeda

Nagahara

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Some authors have advocated for surgery 6-8 , but others have failed to demonstrate a survival benefit for resection [9][10][11][12] . Whether a similar benefit can be achieved in the era of second-and third-generation anticancer agents, which are associated with higher response rates and better overall survival in patients with stage iv crc, is not known.…”

Section: E421mentioning

confidence: 99%

“…Notably, the test for heterogeneity was no longer significant after exclusion from the pool of three studies that had either larger 6,9,12,13,21,23,24 . d Six studies provided information about extent of liver involvement 6,11,12,21,25,26 . e Five studies provided information about peritoneal disease 8,10,21,25,26 .…”

mentioning

confidence: 99%

Should Noncurative Resection of the Primary Tumour Be Performed in Patients with Stage iv Colorectal Cancer? A Systematic Review and Meta-Analysis

et al. 2013

View full text Add to dashboard Cite

rate was 29.7% (95% ci: 18.5% to 41.0%), and the non-resection surgical procedures rate in the nonresection group was 27.6% (95 ci: 15.4% to 39.9%). No study provided qol data. ConclusionsAlthough this review supports primary tumour resection in advanced crc, the results have significant biases. Randomized trials are warranted to confirm the findings. KEY WORDSPrimary tumour resection, stage iv colorectal cancer, palliative surgery, survival INTRODUCTIONColorectal cancer (crc) is one of the leading causes of cancer death in North America 1 . The median overall survival of patients with stage iv crc managed with best supportive care alone is about 5-6 months 2 . Systemic therapy provides meaningful improvements in median survival and progression-free survival. Overall, with the judicious use of novel cytotoxic and biologic agents, the median overall survival of patients with stage iv crc has been extended to approximately 2 years [3][4][5] .The optimal surgical management of stage iv crc that is not amenable to curative resection is unknown. Although administration of systemic therapy in patients with stage iv crc may convert unresectable into resectable disease, the principal goal of treatment in most patients is to prolong survival, and only about 10%-15% patients are alive at 5 years. Consequently, in patients with stage iv crc, the potential morbidity of treatment and the treatment's impact on quality of life (qol) for the patient must be considered.Resection of the primary tumour in patients with stage iv cancer is often performed to deal with presenting primary tumour symptoms and ABSTRACT PurposeSurgical resection of the primary tumour in patients with advanced colorectal cancer (crc) remains controversial. This review compares survival in patients with advanced crc who underwent surgical resection of the primary tumour with that in patients not undergoing resection, and determines rates of postoperative mortality and nonfatal complications, the primary tumour complication rate, the non-resection surgical procedures rate, and quality of life (qol). MethodsReports in the central, medline, and embase databases were searched for relevant studies, which were selected using pre-specified eligibility criteria. The search was also restricted to publication dates from 1980 onward, the English language, and studies involving human subjects. Screening, evaluation of relevant articles, and data abstraction were performed in duplicate, and agreement between the abstractors was assessed. Articles that met the inclusion criteria were assessed for quality using the Newcastle-Ottawa Scale. Data were collected and synthesized per protocol. ResultsFrom among the 3379 reports located, fifteen retrospective observational studies were selected. Of the 12,416 patients in the selected studies, 8620 (69%) underwent surgery. Median survival was 15.2 months (range: 10-30.7 months) in the resection group and 11.4 months (range: 3-22 months) in the nonresection group. Hazard ratio for survival was 0.69 [95% confidence interval (ci): ...

show abstract

“…26 It has also been argued that resection of primary tumour improves survival of palliative patients. 27 Although the study we report on was not specifically designed to analyze survival and the number of patients in the groups is not enough to come to a conclusion, we have observed a difference in clinical behaviour of those two strategies (resection vs stenting or non respective surgery for emergency control of obstruction) that are based on posterior equivalent systemic therapy. We report a medium survival in resected patients of 23.7 months and of 4.4 months in non resected patients.…”

Section: Survival Reportmentioning

confidence: 87%

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Frago

Kreisler

Biondo

et al. 2010

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

First-Line Chemotherapy vs Bowel Tumor Resection Plus Chemotherapy for Patients With Unresectable Synchronous Colorectal Hepatic Metastases

Cited by 114 publications

References 27 publications

Tumor-infiltrating Lymphocytes Predict the Chemotherapeutic Outcomes in Patients with Stage IV Colorectal Cancer

Tumor-infiltrating Lymphocytes Predict the Chemotherapeutic Outcomes in Patients with Stage IV Colorectal Cancer

Should Noncurative Resection of the Primary Tumour Be Performed in Patients with Stage iv Colorectal Cancer? A Systematic Review and Meta-Analysis

Outcomes in the management of obstructive unresectable stage IV colorectal cancer

Contact Info

Product

Resources

About