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Primary tumor resection and overall survival in patients with metastatic colorectal cancer treated with palliative intent

Wong, Shu Fen, Wong, Hui Li, Field, Kathryn M., Kosmider, Suzanne, Tie, Jeanne, Wong, Rachel, Tacey, Mark, Shapiro, Jeremy, Nott, Louise, Richardson, Gary, Cooray, Prasad, Jones, Ian, Croxford, Matthew and Gibbs, Peter 2016, Primary tumor resection and overall survival in patients with metastatic colorectal cancer treated with palliative intent, Clinical colorectal cancer, vol. 15, no. 3, pp. e125-e132, doi: 10.1016/j.clcc.2015.12.010.

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Title Primary tumor resection and overall survival in patients with metastatic colorectal cancer treated with palliative intent
Author(s) Wong, Shu Fen
Wong, Hui Li
Field, Kathryn M.
Kosmider, Suzanne
Tie, Jeanne
Wong, Rachel
Tacey, Mark
Shapiro, Jeremy
Nott, Louise
Richardson, Gary
Cooray, Prasad
Jones, Ian
Croxford, Matthew
Gibbs, Peter
Journal name Clinical colorectal cancer
Volume number 15
Issue number 3
Start page e125
End page e132
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-09
ISSN 1533-0028
1938-0674
Keyword(s) Bowel cancer
Incurable
Prognosis
Surgery
Synchronous neoplasms
Summary The survival impact of primary tumor resection in patients with metastatic colorectal cancer (mCRC) treated with palliative intent remains uncertain. In the absence of randomized data, the objectives of the present study were to examine the effect of primary tumor resection (PTR) and major prognostic variables on overall survival (OS) of patients with de novo mCRC. Patients and Methods: Consecutive patients from the Australian 'Treatment of Recurrent and Advanced Colorectal Cancer' registry were examined from June 2009 to March 2015. Univariate and multivariate Cox proportional hazards regression analyses were used to identify associations between multiple patient or clinical variables and OS. Patients with metachronous mCRC were excluded from the analyses. Results: A total of 690 patients de novo and 373 metachronous mCRC patients treated with palliative intent were identified. The median follow-up period was 30 months. The median age of de novo patients was 66 years; 57% were male; 77% had an Eastern Cooperative Oncology Group performance status of 0 to 1; and 76% had a colon primary. A total of 216 de novo mCRC patients treated with palliative intent underwent PTR at diagnosis and were more likely to have a colon primary (odds ratio [OR], 15.4), a lower carcinoembryonic antigen level (OR, 2.08), and peritoneal involvement (OR, 2.58; P < .001). On multivariate analysis, PTR at diagnosis in de novo patients was not associated with significantly improved OS (hazard ratio [HR], 0.82; 99% confidence interval [CI], 0.62-1.09; P = .068). PTR at diagnosis did not correlate with outcome in de novo patients with a colon primary (HR, 0.74; 99% CI, 0.54-1.01; P = .014) or a rectal primary (HR, 0.81; 99% CI, 0.27-2.44; P = .621). Conclusion: For de novo mCRC patients treated with palliative intent, PTR at diagnosis does not significantly improve OS when adjusting for known major prognostic factors. The outcomes of randomized trials examining the survival impact of PTR are awaited.
Language eng
DOI 10.1016/j.clcc.2015.12.010
Field of Research 111299 Oncology and Carcinogenesis not elsewhere classified
Socio Economic Objective 920102 Cancer and Related Disorders
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082263

Document type: Journal Article
Collection: School of Medicine
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