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Journal of Gastrointestinal Surgery

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01-03-2014 | Original Article

Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis

Authors: Walter Y Tsang, Argyrios Ziogas, Bruce S. Lin, Tara E. Seery, William Karnes, Michael J. Stamos, Jason A. Zell

Published in: Journal of Gastrointestinal Surgery | Issue 3/2014

Abstract

Introduction

The benefit of an operation to remove the primary tumor among patients with synchronous stage IV colorectal cancer is controversial. This study analyzed the survival benefits associated with primary tumor resection among chemotherapy-treated stage IV colorectal cancer patients.

Methods

The study analyzed 11,716 chemotherapy-treated stage IV colorectal cancer patients in the California Cancer Registry between 1996 and 2007, with follow-up through 2009. Patients were stratified into operation and non-operation groups. Estimates of median overall and colorectal cancer-specific survival were generated.

Results

Patients undergoing operation compared to those who are not had higher median overall and colorectal cancer-specific survival, 21 versus 10 months (p < 0.0001) and 22 versus 12 months (p < 0.0001), respectively. Patients who were offered surgery but refused had decreased median overall and colorectal cancer-specific survival when compared to patients who underwent resection, 8 versus 21 months (p < 0.001) and 7 versus 22 months (p < 0.001), respectively. In multivariate regression models, patients who underwent resection of primary tumor had improved overall (hazard ratio (HR), 0.42; 95 % confidence interval (CI) 0.40–0.44, p < 0.0001) and colorectal cancer-specific survival (HR, 0.43; 95 % CI, 0.41–0.45; p < 0.0001).

Conclusion

Primary tumor resection is associated with improved survival among stage IV chemotherapy-treated colorectal cancer patients.

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Title: Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis
Authors: Walter Y Tsang
Argyrios Ziogas
Bruce S. Lin
Tara E. Seery
William Karnes
Michael J. Stamos
Jason A. Zell
Publication date: 01-03-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 3/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2421-0

At a glance: The STEP trials

Springer Medicine

Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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