The Role of Primary Tumor Resection in Colorectal Cancer Patients with Asymptomatic, Synchronous, Unresectable Metastasis: A Multicenter Randomized Controlled Trial
| Autor: | Chang Sik Yu, Eun Jung Park, Hyeong Rok Kim, Bong Hwa Lee, Minkyu Jung, Gyu-Seog Choi, Won Cheol Park, Jae Hwang Kim, Jeong-Heum Baek, Seung Hyuk Baik, Jae Hwan Oh, Sung Bum Kang, Seung-Yong Jeong, Byung Soh Min, Joong Bae Ahn |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Colorectal cancer medicine.medical_treatment overall survival non-curative resection chemotherapy Asymptomatic Gastroenterology lcsh:RC254-282 Article Metastasis law.invention 03 medical and health sciences neoplasm metastasis 0302 clinical medicine Quality of life Randomized controlled trial law synchronous unresectable metastasis Internal medicine medicine Clinical endpoint Chemotherapy business.industry medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Primary tumor primary tumor resection Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology medicine.symptom business colorectal neoplasm |
| Zdroj: | Cancers, Vol 12, Iss 2306, p 2306 (2020) Cancers Volume 12 Issue 8 |
| ISSN: | 2072-6694 |
| Popis: | We aimed to assess the survival benefits of primary tumor resection (PTR) followed by chemotherapy in patients with asymptomatic stage IV colorectal cancer with asymptomatic, synchronous, unresectable metastases compared to those of upfront chemotherapy alone. This was an open-label, prospective, randomized controlled trial (ClnicalTrials.gov Identifier: NCT01978249). From May 2013 to April 2016, 48 patients (PTR, n = 26 upfront chemotherapy, n = 22) diagnosed with asymptomatic colorectal cancer with unresectable metastases in 12 tertiary hospitals were randomized (1:1). The primary endpoint was two-year overall survival. The secondary endpoints were primary tumor-related complications, PTR-related complications, and rate of conversion to resectable status. The two-year cancer-specific survival was significantly higher in the PTR group than in the upfront chemotherapy group (72.3% vs. 47.1% p = 0.049). However, the two-year overall survival rate was not significantly different between the PTR and upfront chemotherapy groups (69.5% vs. 44.8%, p = 0.058). The primary tumor-related complication rate was 22.7%. The PTR-related complication rate was 19.2%, with a major complication rate of 3.8%. The rates of conversion to resectable status were 15.3% and 18.2% in the PTR and upfront chemotherapy groups. While PTR followed by chemotherapy resulted in better two-year cancer-specific survival than upfront chemotherapy, the improvement in the two-year overall survival was not significant. |
| Databáze: | OpenAIRE |
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