Levent Korkmaz1, Hasan Şenol Coşkun2, Faysal Dane3, Bülent Karabulut4, Mustafa Karaağaç1, Devrim Çabuk5, Senem Karabulut6, Nuri Faruk Aykan6, Hatice Doruk7, Nilüfer Avcı8, Nazım Serdar Turhal9, Mehmet Artaç10. 1. Department of Medical Oncology, NecmettinErbakan University, Meram Faculty of Medicine, Konya, Turkey. 2. Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey. 3. Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey. 4. Department of Medical Oncology, Ege University Faculty of Medicine, Izmir, Turkey. 5. Department of Medical Oncology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey. 6. Department of Medical Oncology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey. 7. Department of Medical Oncology, Acıbadem Bursa Hospital, Bursa, Turkey. 8. Department of Medical Oncology, Ali Osman Sönmez Oncology Hospital, Bursa, Turkey. 9. Department of Medical Oncology, Anadolu Medical Center, Istanbul, Turkey. 10. Department of Medical Oncology, NecmettinErbakan University, Meram Faculty of Medicine, Konya, Turkey. Electronic address: mehmetartac@yahoo.com.
Abstract
PURPOSE: We aimed to investigate the prognostic effect of primary tumor resection (PTR) prior to bevacizumab-based treatments in unresectable metastatic colorectal cancer (mCRC). METHODS: We retrospectively collected 341 mCRC cases with unresectable metastases at diagnosis. PTR was performed in 210 cases (the surgery group) and the other patients (n = 131) were followed without PTR (the no-surgery group). All the patients were treated with bevacizumab combined chemotherapy regimens. RESULTS: The median progression free survival (PFS) of the surgery group was 10.4 months (95% CI: 8.9-11.9), which was significantly better than that of the no-surgery group (7.6 months, 95% CI: 6.4-8.8, P=0.000). The median overall survival (OS) of the surgery group was longer than that of the no-surgery group (27.4 months vs. 18.3 months, respectively, P=0.000). The median PFS and OS of the surgery group were 10.4 months and 28.2 months, which were significantly longer than that of the no-surgery group in Kras-mutant patients (7.8 months and 18.3 months; P=0.004, P=0.028, respectively). There was no difference in terms of PFS and OS between the surgery and the no-surgery groups in Kras-wild type patients. CONCLUSION: Palliative PTR may improve the survival outcomes for unresectable mCRC patients. PTR may be preferred, particularly in Kras-mutant patients.
PURPOSE: We aimed to investigate the prognostic effect of primary tumor resection (PTR) prior to bevacizumab-based treatments in unresectable metastatic colorectal cancer (mCRC). METHODS: We retrospectively collected 341 mCRC cases with unresectable metastases at diagnosis. PTR was performed in 210 cases (the surgery group) and the other patients (n = 131) were followed without PTR (the no-surgery group). All the patients were treated with bevacizumab combined chemotherapy regimens. RESULTS: The median progression free survival (PFS) of the surgery group was 10.4 months (95% CI: 8.9-11.9), which was significantly better than that of the no-surgery group (7.6 months, 95% CI: 6.4-8.8, P=0.000). The median overall survival (OS) of the surgery group was longer than that of the no-surgery group (27.4 months vs. 18.3 months, respectively, P=0.000). The median PFS and OS of the surgery group were 10.4 months and 28.2 months, which were significantly longer than that of the no-surgery group in Kras-mutant patients (7.8 months and 18.3 months; P=0.004, P=0.028, respectively). There was no difference in terms of PFS and OS between the surgery and the no-surgery groups in Kras-wild type patients. CONCLUSION: Palliative PTR may improve the survival outcomes for unresectable mCRC patients. PTR may be preferred, particularly in Kras-mutant patients.