Meta-analysis of Survival of Patients with Stage 4 Colorectal Cancer Managed with Resection versus Chemotherapy Alone: Letter to the Editor

Excerpt

In their article Stillwell et al. conclude that, to avoid tumor-related complications, asymptomatic patients presenting with metastatic colorectal cancer should undergo resection of the primary tumor [1]. While this observation may once have been correct, we believe that recent advances in medical oncology warrant re-examination of this assertion. In the last decade five new chemotherapeutic agents (irinotecan, capecitabine, oxaliplatin, bevacizumab, and cetuximab) have been approved, and a number of effective regimens have been developed, broadening the armamentarium against metastatic colorectal cancer. Clinical trials have demonstrated an increase in median survival in patients with metastatic colorectal cancer from 6–8 months with supportive care alone to more than 20 months with the use of combination chemotherapy [2]. As a result, the view of metastatic colorectal cancer has changed from an acute condition and a certain death sentence to, potentially, a chronic condition, that patients live with but do not die from [2]. …