Prognostic Value of Resection of Primary Tumor in Patients with Stage IV Colorectal Cancer: Retrospective Analysis of Two Randomized Studies and a Review of the Literature

Autor: Aart van Bochove, Linda Mol, Johannes H. W. de Wilt, Steven Teerenstra, Geert-Jan Creemers, Olaf Loosveld, Sabine Venderbosch, Margot E T Tesselaar, Miriam Koopman, Cornelis J. A. Punt, Harm Sinnige
Rok vydání: 2012
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Stage IV Colorectal Cancer
Colorectal cancer
Quality of nursing and allied health care [NCEBP 6]
Asymptomatic
Quality of Care [ONCOL 4]
Resection
Original Article–Colorectal Cancer
Translational research [ONCOL 3]
Surgical oncology
Internal medicine
medicine
Retrospective analysis
Humans
In patient
Survival rate
Aged
Neoplasm Staging
Randomized Controlled Trials as Topic
Retrospective Studies
Aged
80 and over
Cetuximab
business.industry
Retrospective cohort study
Middle Aged
Prognosis
medicine.disease
Primary tumor
digestive system diseases
Survival Rate
Clinical trial
Review Literature as Topic
Clinical Trials
Phase III as Topic
Evaluation of complex medical interventions [NCEBP 2]
Female
Surgery
medicine.symptom
Colorectal Neoplasms
business
medicine.drug
Zdroj: Annals of Surgical Oncology, 18, 3252-60
Annals of Surgical Oncology, 18, 12, pp. 3252-60
ISSN: 0976-6952
0975-7651
1068-9265
DOI: 10.1007/s13193-012-0157-z
Popis: Item does not contain fulltext BACKGROUND: In patients with metastatic colorectal cancer (mCRC) with an asymptomatic primary tumor, there is no consensus on the indication for resection of the primary tumor. METHODS: A retrospective analysis was performed on the outcome of stage IV colorectal cancer (CRC) patients with or without resection of the primary tumor treated in the phase III CAIRO and CAIRO2 studies. A review of the literature was performed. RESULTS: In the CAIRO and CAIRO2 studies, 258 and 289 patients had undergone a primary tumor resection and 141 and 159 patients had not, respectively. In the CAIRO study, a significantly better median overall survival and progression-free survival was observed for the resection compared to the nonresection group, with 16.7 vs. 11.4 months [P < 0.0001, hazard ratio (HR) 0.61], and 6.7 vs. 5.9 months (P = 0.004; HR 0.74), respectively. In the CAIRO2 study, median overall survival and progression-free survival were also significantly better for the resection compared to the nonresection group, with 20.7 vs. 13.4 months (P < 0.0001; HR 0.65) and 10.5 vs. 7.8 months (P = 0.014; HR 0.78), respectively. These differences remained significant in multivariate analyses. Our review identified 22 nonrandomized studies, most of which showed improved survival for mCRC patients who underwent resection of the primary tumor. CONCLUSIONS: Our results as well as data from literature indicate that resection of the primary tumor is a prognostic factor for survival in stage IV CRC patients. The potential bias of these results warrants prospective studies on the value of resection of primary tumor in this setting; such studies are currently being planned.
Databáze: OpenAIRE
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