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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2017

Open Access 01-12-2017 | Research

Primary tumor location as a predictor of the benefit of palliative resection for colorectal cancer with unresectable metastasis

Authors: Rong-xin Zhang, Wen-juan Ma, Yu-ting Gu, Tian-qi Zhang, Zhi-mei Huang, Zhen-hai Lu, Yang-kui Gu

Published in: World Journal of Surgical Oncology | Issue 1/2017

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Abstract

Background

It is still under debate that whether stage IV colorectal cancer patients with unresectable metastasis can benefit from primary tumor resection, especially for asymptomatic colorectal cancer patients. Retrospective studies have shown controversial results concerning the benefit from surgery. This retrospective study aims to evaluate whether the site of primary tumor is a predictor of palliative resection in asymptomatic stage IV colorectal cancer patients.

Methods

One hundred ninety-four patients with unresectable metastatic colorectal cancer were selected from Sun Yat-sen University Cancer Center Database in the period between January 2007 and December 2013. All information was carefully reviewed and collected, including the treatment, age, sex, carcinoembryonic antigen, site of tumor, histology, cancer antigen 199, number of liver metastases, and largest diameter of liver metastasis. The univariate and multivariate analyses were used to detect the relationship between primary tumor resection and overall survival of unresectable stage IV colorectal cancer patients.

Results

One hundred twenty-five received palliative resection, and 69 received only chemotherapy. Multivariate analysis indicated that primary tumor site was one of the independent factors (RR 0.569, P = 0.007) that influenced overall survival. For left-side colon cancer patients, primary tumor resection prolonged the median overall survival time for 8 months (palliative resection vs. no palliative resection: 22 vs. 14 months, P = 0.009); however, for right-side colon cancer patients, palliative resection showed no benefit (12 vs. 10 months, P = 0.910).

Conclusions

This study showed that left-side colon cancer patients might benefit from the primary tumor resection in terms of overall survival. This result should be further explored in a prospective study.
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Metadata
Title
Primary tumor location as a predictor of the benefit of palliative resection for colorectal cancer with unresectable metastasis
Authors
Rong-xin Zhang
Wen-juan Ma
Yu-ting Gu
Tian-qi Zhang
Zhi-mei Huang
Zhen-hai Lu
Yang-kui Gu
Publication date
01-12-2017
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2017
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-017-1198-0

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