PURPOSE: Retrospective studies have shown that primary tumor resection improves the prognosis of patients with colorectal cancer (CRC) with unresectable metastasis (mCRC). The aim of this study was to investigate the prognostic impact of primary tumor resection in various subgroups of mCRC patients. METHODS: A total of 1982 patients with mCRC from January 1997 to December 2007 were retrospectively evaluated. The impact of primary tumor resection on cancer-specific survival (CSS) was analyzed using propensity score analysis to mitigate selection bias. Covariates in the models for propensity scores included treatment period, age, gender, tumor location, depth, lymph node metastasis, number of metastatic organs, and carcinoembryonic antigen (CEA) levels. RESULTS: Among the whole patient population, primary tumor resection significantly improved CSS [hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.32-0.66, p < 0.01]. However, primary tumor resection did not significantly improve CSS in the following subgroups: patients treated in the first 5 years of the study (HR 0.56, 95% CI 0.28-1.13, p = 0.08), patients aged >65 years (HR 0.72, 95% CI 0.36-1.42, p = 0.31), female patients (HR 0.60, 95% CI 0.31-1.17, p = 0.13), patients with right-sided colon cancer (HR 0.68, 95% CI 0.39-1.20, p = 0.17), and patients without nodal involvement (HR 0.54, 95% CI 0.25-1.17, p = 0.09). CONCLUSIONS: Our study suggests that primary tumor resection improves the survival of patients with mCRC. However, the prognostic benefit is different among patient subpopulations.
PURPOSE: Retrospective studies have shown that primary tumor resection improves the prognosis of patients with colorectal cancer (CRC) with unresectable metastasis (mCRC). The aim of this study was to investigate the prognostic impact of primary tumor resection in various subgroups of mCRC patients. METHODS: A total of 1982 patients with mCRC from January 1997 to December 2007 were retrospectively evaluated. The impact of primary tumor resection on cancer-specific survival (CSS) was analyzed using propensity score analysis to mitigate selection bias. Covariates in the models for propensity scores included treatment period, age, gender, tumor location, depth, lymph node metastasis, number of metastatic organs, and carcinoembryonic antigen (CEA) levels. RESULTS: Among the whole patient population, primary tumor resection significantly improved CSS [hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.32-0.66, p < 0.01]. However, primary tumor resection did not significantly improve CSS in the following subgroups: patients treated in the first 5 years of the study (HR 0.56, 95% CI 0.28-1.13, p = 0.08), patients aged >65 years (HR 0.72, 95% CI 0.36-1.42, p = 0.31), female patients (HR 0.60, 95% CI 0.31-1.17, p = 0.13), patients with right-sided colon cancer (HR 0.68, 95% CI 0.39-1.20, p = 0.17), and patients without nodal involvement (HR 0.54, 95% CI 0.25-1.17, p = 0.09). CONCLUSIONS: Our study suggests that primary tumor resection improves the survival of patients with mCRC. However, the prognostic benefit is different among patient subpopulations.
Authors: James R Nitzkorski; Jeffrey M Farma; James C Watson; Veeraiah Siripurapu; Fang Zhu; Ronald S Matteotti; Elin R Sigurdson Journal: Ann Surg Oncol Date: 2011-08-23 Impact factor: 5.344
Authors: N J van Leersum; M L G Janssen-Heijnen; M W J M Wouters; H J T Rutten; J W Coebergh; R A E M Tollenaar; V E P P Lemmens Journal: Int J Cancer Date: 2012-11-05 Impact factor: 7.396
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Tess V Clendenen; Karen L Koenig; Roy E Shore; Mortimer Levitz; Alan A Arslan; Anne Zeleniuch-Jacquotte Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-01 Impact factor: 4.254
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
Authors: Narimantas E Samalavicius; Audrius Dulskas; Edita Baltruskeviciene; Giedre Smailyte; Marija Skuciene; Rasa Mikelenaite; Rasa Venslovaite; Eduardas Aleknavicius; Almantas Samalavicius; Raimundas Lunevicius Journal: Wideochir Inne Tech Maloinwazyjne Date: 2016-12-31 Impact factor: 1.195