Nüvit Duraker1, Zeynep Civelek Çaynak2, Semih Hot3. 1. Department of Surgery, SB Okmeydanı Training and Research Hospital, İstanbul, Turkey. Electronic address: nuvitduraker@gmail.com. 2. Department of Surgery, Bayındır Levent Hospital, İstanbul, Turkey. 3. Department of Surgery, SB Okmeydanı Training and Research Hospital, İstanbul, Turkey.
Abstract
BACKGROUND: To compare the patients with primary colorectal carcinoma (CRC) and non-resectable distant metastases with or without primary colorectal tumor resection as a primary treatment in terms of postoperative mortality and overall survival (OS). PATIENTS AND METHODS: The clinicopathological data of 188 CRC patients with non-resectable distant metastases was analyzed. All patient data were collected prospectively. Colorectal tumor was resected in 121 patients (64.3%). Kaplan-Meier method was used for calculation and plotting of the OS curves of the patient groups, and log-rank test was used for the comparison of the survival curves. The relative importance of the prognostic features was investigated using the Cox proportional hazards model. RESULTS: In the whole series and in the patient group undergoing emergency surgical intervention, mortality rate was lower in patients having colorectal tumor resection compared with non-resected patients, with differences approaching the significance level (p = 0.072 and p = 0.076, respectively). Median OS time was significantly longer in resection group (11.0 months), compared with non-resection group (5.5 months) (p < 0.001); in the multivariate Cox analysis colorectal tumor resection had independent prognostic significance (p < 0.001). CONCLUSION: Resection of colorectal tumor in primary CRC patients with non-resectable distant metastasis gives significant survival advantage without increasing postoperative mortality compared with non-resection.
BACKGROUND: To compare the patients with primary colorectal carcinoma (CRC) and non-resectable distant metastases with or without primary colorectal tumor resection as a primary treatment in terms of postoperative mortality and overall survival (OS). PATIENTS AND METHODS: The clinicopathological data of 188 CRCpatients with non-resectable distant metastases was analyzed. All patient data were collected prospectively. Colorectal tumor was resected in 121 patients (64.3%). Kaplan-Meier method was used for calculation and plotting of the OS curves of the patient groups, and log-rank test was used for the comparison of the survival curves. The relative importance of the prognostic features was investigated using the Cox proportional hazards model. RESULTS: In the whole series and in the patient group undergoing emergency surgical intervention, mortality rate was lower in patients having colorectal tumor resection compared with non-resected patients, with differences approaching the significance level (p = 0.072 and p = 0.076, respectively). Median OS time was significantly longer in resection group (11.0 months), compared with non-resection group (5.5 months) (p < 0.001); in the multivariate Cox analysis colorectal tumor resection had independent prognostic significance (p < 0.001). CONCLUSION: Resection of colorectal tumor in primary CRCpatients with non-resectable distant metastasis gives significant survival advantage without increasing postoperative mortality compared with non-resection.
Authors: Zeinab Alawadi; Uma R Phatak; Chung-Yuan Hu; Christina E Bailey; Y Nancy You; Lillian S Kao; Nader N Massarweh; Barry W Feig; Miguel A Rodriguez-Bigas; John M Skibber; George J Chang Journal: Cancer Date: 2016-08-01 Impact factor: 6.860
Authors: Constantinos Simillis; Eliana Kalakouti; Thalia Afxentiou; Christos Kontovounisios; Jason J Smith; David Cunningham; Michel Adamina; Paris P Tekkis Journal: World J Surg Date: 2019-07 Impact factor: 3.352