Debate continues regarding the benefit of primary tumour resection for patients with asymptomatic metastatic colorectal cancer; the largest observational study conducted to date has demonstrated prolonged survival, but was probably subject to biases, and data from previous meta-analyses of observational data are contradictory. The results of two ongoing randomized trials are eagerly awaited. In the meantime, treatment should be directed at symptom palliation.
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References
Tarantino, I. et al. Prognostic relevance of palliative primary tumor removal in 37,793 metastatic colorectal cancer patients: a population-based, propensity score-adjusted trend analysis. Ann. Surg. http://dx.doi.org/10.1097/SLA.0000000000000860.
Cirocchi, R. et al. Non-resection versus resection for an asymptomatic primary tumour in patients with unresectable stage IV colorectal cancer. Cochrane Database of Systematic Reviews, Issue 8. Art. No.: CD004549 http://dx.doi.org/10.1002/14651858.CD008997.pub2 (2012).
Yun, J. A. et al. The role of palliative resection for asymptomatic primary tumor in patients with unresectable stage IV colorectal cancer. Dis. Colon Rectum 57, 1049–1058 (2014).
Ahmed, S. et al. Should noncurative resection of the primary tumour be performed in patients with stage IV colorectal cancer? A systematic review and meta-analysis. Curr. Oncol. 20, e420–e441 (2013).
US National Library of Medicine. ClinicalTrials.gov [online], (2013).
BioMed Central. ISRCTN registry [online], (2013).
US National Library of Medicine. ClinicalTrials.gov [online], (2014).
Poultsides, G. A. et al. Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment. J. Clin. Oncol. 27, 3379–3384 (2009).
van den Broek, C. B. et al. Differences in pre-operative treatment for rectal cancer between Norway, Sweden, Denmark, Belgium and the Netherlands. Eur. J. Surg. Oncol. 40, 1789–1796 (2014).
Breugom, A. J. et al. Quality assurance in the treatment of colorectal cancer: the EURECCA initiative. Ann. Oncol. 25, 1485–1492 (2014).
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van de Velde, C. Palliative primary tumour resection in mCRC—debate continues. Nat Rev Clin Oncol 12, 129–130 (2015). https://doi.org/10.1038/nrclinonc.2015.7
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DOI: https://doi.org/10.1038/nrclinonc.2015.7
