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Review
. 2017 Oct 30;34(12):188.
doi: 10.1007/s12032-017-1047-6.

Primary tumor resection in stage IV unresectable colorectal cancer: what has changed?

Michał Pędziwiatr  1   2 , Magdalena Mizera  3 , Jan Witowski  3   4 , Piotr Major  3   4 , Grzegorz Torbicz  3 , Natalia Gajewska  3 , Andrzej Budzyński  3   4
Affiliations
Review

Primary tumor resection in stage IV unresectable colorectal cancer: what has changed?

Michał Pędziwiatr et al. Med Oncol. .

Abstract

Most current guidelines do not recommend primary tumor resection in stage IV unresectable colorectal cancer. Rapid chemotherapy development over the last decade has substantially changed the decision making. However, results of recently published trials and meta-analyses suggest that primary tumor resection may in fact be beneficial, principally in terms of prolonged survival. Additional factors, such as use of minimally invasive approach or protocols of enhanced recovery after surgery, affect clinical outcomes as well, but are often neglected when discussing the state of the art in this area. There are still no randomized studies determining the legitimacy of upfront surgery in asymptomatic patients. Also, quality of life also plays an important role in choosing appropriate treatment. Having said that, there is no data that would prove whether primary tumor resection has an advantage on that issue. With all the uncertainty, currently decision making in unresectable stage IV colorectal cancer is primarily up to clinicians' knowledge, common sense and patients' preferences.

Keywords: Decision making; Primary tumor resection; Stage IV colorectal cancer; Unresectable colorectal cancer.

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Conflict of interest statement

Conflict of interest

All authors declare that they have no conflicts of interest.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

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