Primary Tumour Treatment in Stage 4 Colorectal Cancer with Unresectable Liver and Lung Metastases and No Peritoneal Carcinomatosis—Current Trends and Attitudes in the Absence of Clear Guidelines

Autor: Collaborative, Giovanni Domenico Tebala, Antonio Di Cintio, Francesco Ricci, Stefano Avenia, Roberto Cirocchi, Jacopo Desiderio, Domenico Di Nardo, Salomone Di Saverio, Alessandro Gemini, Maria Chiara Ranucci, Stefano Trastulli, Fabio Cianchi, Marco Scatizzi, Fausto Catena, the MeCC-4 International Collaborative the MeCC-4 International
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Clinical Medicine; Volume 12; Issue 10; Pages: 3499
ISSN: 2077-0383
DOI: 10.3390/jcm12103499
Popis: Background: The treatment of the primary tumour in colorectal cancer with unresectable liver and/or lung metastases but no peritoneal carcinomatosis is still a matter of debate. In the absence of clear evidence and guidelines, our survey was aimed at obtaining a snapshot of the current attitudes and the rationales for the choice of offering resection of the primary tumour (RPT) despite the presence of untreatable metastases. Methods: An online survey was administered to medical professionals worldwide. The survey had three sections: (1) demographics of the respondent, (2) case scenarios and (3) general questions. For each respondent, an “elective resection score” and an “emergency resection score” were calculated as a percentage of the times he or she would offer RPT in the elective and in the emergency case scenarios. They were correlated to independent variables such as age, type of affiliation and specific workload. Results: Most respondents would offer palliative chemotherapy as the first choice in elective scenarios, while a more aggressive approach with RPT would be reserved for younger patients with good performance status and in emergency situations. Respondents younger than 50 years old and those with a specific workload of fewer than 40 cases of colorectal cancer per year tend to be more conservative. Conclusions: In the absence of clear guidelines and evidence, there is a lack of consensus on the treatment of the primary tumour in case of colon cancer with unresectable liver and/or lung metastases and no peritoneal carcinomatosis. Palliative chemotherapy seems to be the first option, but more consistent evidence is needed to guide this choice.
Databáze: OpenAIRE
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