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Elective palliative resection of incurable stage IV colorectal cancer: Who really benefits from it?

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Abstract

Purpose

Despite the encouraging results of chemotherapy in patients affected by incurable colorectal cancer (CRC), surgical resection of a primitive tumor is still a common approach worldwide. The identification of prognostic factors related to short survival (<6 months) may allow excluding from resective surgery those who may not benefit from it.

Methods

A retrospective analysis was performed of 15 variables in a population of 71 patients undergoing nonemergency palliative primary resections of incurable CRC, including patients’ demographics and clinical/histopathological characteristics of the tumor.

Results

No variables were related to perioperative mortality (8.5% overall). A multivariate analysis revealed that older age (≥80 years) and metastasis to more than 25% of the lymph nodes were associated with survival (4 and 6 months, respectively). Mucoid adenocarcinoma therefore tends to be associated with the prognosis (P = 0.070).

Conclusions

An elderly age tends to be a contraindication to an elective primary tumor resection in patients affected by incurable CRC. Massive lymph node involvement and mucoid adenocarcinoma should also be considered before planning major colonic surgery.

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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche, Università di Parma, Via Gramsci 14, 43100, Parma, Italy

    Renato Costi, Davide Di Mauro, Pierfranco Salcuni, Luigi Roncoroni, Leopoldo Sarli & Vincenzo Violi

  2. Dipartimento di Sanità Pubblica, Università di Parma, Via Gramsci 14, 43100, Parma, Italy

    Licia Veronesi

  3. Service de Chirurgie Digestive et Endocrinienne, Hôpital Cochin, AP-HP, Paris, France

    Renato Costi

  4. Divisione di Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    Andrea Ardizzoni

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  1. Renato Costi
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Costi, R., Di Mauro, D., Veronesi, L. et al. Elective palliative resection of incurable stage IV colorectal cancer: Who really benefits from it?. Surg Today 41, 222–229 (2011). https://doi.org/10.1007/s00595-009-4253-9

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  • DOI: https://doi.org/10.1007/s00595-009-4253-9

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