PMID- 32174986
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240328
IS  - 1735-1995 (Print)
IS  - 1735-7136 (Electronic)
IS  - 1735-1995 (Linking)
VI  - 25
DP  - 2020
TI  - Does primary tumor resection contribute to overall survival in unresectable 
      synchronous metastatic colorectal cancer?
PG  - 14
LID - 10.4103/jrms.JRMS_1056_18 [doi]
LID - 14
AB  - BACKGROUND: Primary tumor resection (PTR) in metastatic colorectal cancer (mCRC) 
      has not been suggested by guidelines, since new systemic chemotherapy options 
      have improved overall survival. However, the effect of PTR is still controversial 
      in mCRC. In this study, we aimed to evaluate the effect of PTR on survival in 
      unresectable mCRC. MATERIALS AND METHODS: Two hundred and fifty-two patients with 
      unresectable mCRC were screened retrospectively between January 2007 and December 
      2017 and a total of 147 patients who met inclusion criteria were included. The 
      patients with emergency or elective PTR and the patients without surgery were 
      compared for baseline features and overall survival. RESULTS: The median 
      follow-up time was 15.6 months (range; 1.2-78.9) in whole patients. There were 91 
      patients in nonsurgical (NS) group and 56 patients in PTR group. The median 
      overall survival was significantly longer in PTR group compared NS group (21.8 
      vs. 17.0 months, P = 0.01), but it was not associated to better overall survival 
      in multivariate Cox analysis (hazard ratio: 0.65, 95% confidence interval: 
      0.41-1.02, P = 0.06). There was no significant difference in overall survival 
      between emergency and elective surgery subgroups (22.9 vs. 16.1 months, 
      respectively, P = 0.9). CONCLUSION: PTR did not offer an overall survival benefit 
      in this study. Although it is debated, we think that it is better to start 
      treatment with chemotherapy and biological agent combinations in patients with 
      asymptomatic mCRC. Thus, the patients can be protected from the morbidity and 
      mortality of the surgery.
CI  - Copyright: (c) 2020 Journal of Research in Medical Sciences.
FAU - Ergun, Yakup
AU  - Ergun Y
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Bal, Oznur
AU  - Bal O
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Dogan, Mutlu
AU  - Dogan M
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Ucar, Gokhan
AU  - Ucar G
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Dirikoc, Merve
AU  - Dirikoc M
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Acikgoz, Yusuf
AU  - Acikgoz Y
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
FAU - Bacaksiz, Ferhat
AU  - Bacaksiz F
AD  - Department of Gastroenterology, Yuksek Ihtisas Training and Research Hospital, 
      Ankara, Turkey.
FAU - Uncu, Dogan
AU  - Uncu D
AD  - Department of Medical Oncology, Ankara Numune Training and Research Hospital, 
      Ankara, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20200220
PL  - India
TA  - J Res Med Sci
JT  - Journal of research in medical sciences : the official journal of Isfahan 
      University of Medical Sciences
JID - 101235599
PMC - PMC7053176
OTO - NOTNLM
OT  - Colectomy
OT  - colorectal cancer
OT  - metastatic
OT  - palliative surgery
OT  - survival
COIS- There are no conflicts of interest.
EDAT- 2020/03/17 06:00
MHDA- 2020/03/17 06:01
PMCR- 2020/02/20
CRDT- 2020/03/17 06:00
PHST- 2018/12/31 00:00 [received]
PHST- 2019/02/15 00:00 [revised]
PHST- 2019/11/22 00:00 [accepted]
PHST- 2020/03/17 06:00 [entrez]
PHST- 2020/03/17 06:00 [pubmed]
PHST- 2020/03/17 06:01 [medline]
PHST- 2020/02/20 00:00 [pmc-release]
AID - JRMS-25-14 [pii]
AID - 10.4103/jrms.JRMS_1056_18 [doi]
PST - epublish
SO  - J Res Med Sci. 2020 Feb 20;25:14. doi: 10.4103/jrms.JRMS_1056_18. eCollection 
      2020.