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. 2013 Apr 16;108(7):1425-31.
doi: 10.1038/bjc.2013.94. Epub 2013 Mar 12.

The beneficial effect of palliative resection in metastatic colorectal cancer

J H Park  1 , T-Y Kim, K-H Lee, S-W Han, D-Y Oh, S-A Im, G H Kang, E K Chie, S W Ha, S-Y Jeong, K J Park, J-G Park, T-Y Kim
Affiliations

The beneficial effect of palliative resection in metastatic colorectal cancer

J H Park et al. Br J Cancer. .

Abstract

Background: We aimed to determine the role of palliative resection in metastatic colorectal cancer (mCRC) and ascertain which patient populations would benefit most from this treatment.

Methods: A total of 1015 patients diagnosed with mCRC at Seoul National University Hospital between 2000 and 2009 were retrospectively studied.

Results: Of the 1015 patients, 168 patients with only liver and/or lung metastasis received curative resection. The remaining 847 patients were treated with palliative chemotherapy and/or palliative resection combined with best supportive care. Palliative resection was performed in 527 (62.2%) cases (complete resection with negative margin (R0) in 93, R1/2 in 434). Resected patients had a more prolonged median overall survival (OS) than unresected patients (21.3 vs 14.1 months; P<0.001). In multivariate analysis, R0 resection was found to be associated with a superior OS compared with R1/2 resection (51.3 vs 19.1 months; P<0.001) and no resection (51.3 vs 14.1 months; P<0.001). When we performed propensity score matching, palliative resection was found to be related to prolonged OS (hazard ratio=0.72, 95% confidence interval=0.59-0.89; P=0.003).

Conclusion: Palliative resection without residual disease and chemotherapy confers a longer-term survival outcome than palliative chemotherapy alone in mCRC patient subset.

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Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) diagram.
Figure 2
Figure 2
Kaplan–Meier plots of OS in mCRC patients who received curative surgery (A) and in patients who were not candidates for curative resection (B).
Figure 3
Figure 3
Kaplan–Meier plots of OS based on palliative resection (A) and extent of palliative resection (B) in mCRC cases.
Figure 4
Figure 4
The effects of palliative resection on survival in mCRC patients by subgroup analysis.
Figure 5
Figure 5
Kaplan–Meier plot of OS with propensity score matching according to palliative resection in mCRC cases.
See this image and copyright information in PMC

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