Primary site resection is superior for incurable metastatic colorectal cancer

Tanoue, Yusuke; Tanaka, Nobutaka; Nomura, Yukihiro

doi:10.3748/wjg.v16.i28.3561

Cited by 15 publications

(15 citation statements)

References 17 publications

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“…Our key finding of the association of PTR with improved OS, regardless of chemotherapy administration, is interesting. This result is in consistent with other retrospective studies and meta‐analyses that have shown a survival benefit of PTR. In our cohort the decision for elective palliative PTR was based on multidisciplinary tumor board discussions.…”

Section: Discussionsupporting

confidence: 93%

Survival outcomes following primary tumor resection for patients with incurable metastatic colorectal carcinoma: Experience from a single institution

Lau

Chang

Lee

et al. 2018

J of Digest Diseases

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Section: Discussionsupporting

confidence: 93%

Survival outcomes following primary tumor resection for patients with incurable metastatic colorectal carcinoma: Experience from a single institution

Lau

Chang

Lee

et al. 2018

J of Digest Diseases

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“…Of twenty-three full-text articles that were excluded, twelve had no comparator nonsurgical group [27][28][29][30][31][32][33][34][35][36][37][38] ; four used a non-resection group (that is, ostomy procedures) as comparators [39][40][41][42] ; and another four used patients who underwent curative surgery as the comparator group [43][44][45][46] . Two studies, each with four comparator groups, provided minimal information about those groups, and one had a patient population that overlapped with the population of another study included in the present review 14,47 .…”

Section: Study Selectionmentioning

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

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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): ...

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“…A primary resection does ensure that the primary cancer is removed, preventing perforation and stenosis and improving the likelihood of survival, as we also found in the present study. Although a previous study showed that primary site resection has benefits for incurable metastatic CRC [19], the results of prospective randomized studies are awaited, such as the JCOG1007 trial comparing resection of the primary tumor plus chemotherapy with chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Incurable Stage IV Colorectal Cancer

Munakata¹,

Sugimoto²,

Honjo³

et al. 2018

OJGas

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Objectives: Our aim is investigating the predictive potential of these available and convenient laboratory dates in stage IV colorectal cancer (CRC) patients. Methods: We identified the cases of 114 consecutive patients who underwent the surgery at our Hospital between January 2006 and December 2012 by using the multivariate analysis, the Cox proportional-hazard regression model. Results: Multivariate analysis for the predictors of survival showed metastatic lesion resection [hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.6-6.6; p = 0.007] and only primary lesion resection (HR = 1.9, 95% CI 1.1-4.0; p = 0.045) remained independently significant prognostic factors. Therefore, we divided in 3 groups, 1) metastatic lesion resection group with primary lesion resection (n = 52 in the Met/Prim lesion group), 2) primary lesion resection without metastatic lesion resection (n = 38 in the Primary lesion group) and 3) palliative operation (n = 24 in the Palliative group). Age was the only independent risk factor in the Met/Prim lesion group. In the Primary lesion group, Neutrophil lymphocyte ratio (NLR) > 5, elevated Alanine aminotransferase and patients without chemotherapy were correlated with poor survival. In the Palliative group, NLR > 5 and patients who could not be treated with chemotherapy remained independent predictors of worse survival. Conclusions: NLR is not only simple and convenient for classification of patients, but also one of the important predictors of mortality for stage IV incurable CRC patients.

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Primary site resection is superior for incurable metastatic colorectal cancer

Abstract: The results indicate that there are benefits from primary site resection for incurable metastatic colorectal cancer with systemic chemotherapy.

Cited by 15 publications

References 17 publications

Survival outcomes following primary tumor resection for patients with incurable metastatic colorectal carcinoma: Experience from a single institution

Survival outcomes following primary tumor resection for patients with incurable metastatic colorectal carcinoma: Experience from a single institution

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

Neutrophil-Lymphocyte Ratio as a Prognostic Factor in Incurable Stage IV Colorectal Cancer

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