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Primary Tumor Resection in Colorectal Cancer with Unresectable Synchronous Metastasis: Time to Reconsider the Role of the Surgeon

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References

  1. Fujita Y, Hida K, Hoshino N, et al. Impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer: a multicenter retrospective cohort study. Ann Gastroenterol Surg. 2021;5(3):354–62.

    Article  Google Scholar 

  2. Alawadi Z, Phatak UR, Hu CY, et al. Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer. Cancer. 2017;123(7):1124–33.

    Article  Google Scholar 

  3. Clancy C, Burke JP, Barry M, Kalady MF, Calvin Coffey J. A meta-analysis to determine the effect of primary tumor resection for stage IV colorectal cancer with unresectable metastases on patient survival. Ann Surg Oncol. 2014;21(12):3900–8.

    Article  Google Scholar 

  4. Faron M, Pignon JP, Malka D, et al. Is primary tumour resection associated with survival improvement in patients with colorectal cancer and unresectable synchronous metastases? A pooled analysis of individual data from four randomised trials. Eur J Cancer. 2015;51(2):166–76.

    Article  Google Scholar 

  5. Gulack BC, Nussbaum DP, Keenan JE, et al. Surgical resection of the primary tumor in stage IV colorectal cancer without metastasectomy is associated with improved overall survival compared with chemotherapy/radiation therapy alone. Dis Colon Rectum. 2016;59(4):299–305.

    Article  Google Scholar 

  6. Ishihara S, Hayama T, Yamada H, et al. Prognostic impact of primary tumor resection and lymph node dissection in stage IV colorectal cancer with unresectable metastasis: a propensity score analysis in a multicenter retrospective study. Ann Surg Oncol. 2014;21(9):2949–55.

    Article  Google Scholar 

  7. Sterpetti AV, Costi U, D’Ermo G. National statistics about resection of the primary tumor in asymptomatic patients with Stage IV colorectal cancer and unresectable metastases. Need for improvement in data collection. A systematic review with meta-analysis. Surg Oncol. 2020;33:11–8.

    Article  Google Scholar 

  8. van Rooijen KL, Shi Q, Goey KKH, et al. Prognostic value of primary tumour resection in synchronous metastatic colorectal cancer: individual patient data analysis of first-line randomised trials from the ARCAD database. Eur J Cancer. 2018;91:99–106.

    Article  Google Scholar 

  9. de Mestier L, Manceau G, Neuzillet C, et al. Primary tumor resection in colorectal cancer with unresectable synchronous metastases: a review. World J Gastrointest Oncol. 2014;6(6):156–69.

    Article  Google Scholar 

  10. van der Wal GE, Gouw AS, Kamps JA, et al. Angiogenesis in synchronous and metachronous colorectal liver metastases: the liver as a permissive soil. Ann Surg. 2012;255(1):86–94.

    Article  Google Scholar 

  11. Xu H, Xia Z, Jia X, et al. Primary tumor resection is associated with improved survival in stage IV colorectal cancer: an instrumental variable analysis. Sci Rep. 2015;5:16516.

    Article  Google Scholar 

  12. Kanemitsu Y, Shitara K, Mizusawa J, et al. Primary tumor resection plus chemotherapy versus chemotherapy alone for colorectal cancer patients with asymptomatic, synchronous unresectable metastases (JCOG1007; iPACS): a randomized clinical trial. J Clin Oncol. 2021;39(10):1098–107.

    Article  Google Scholar 

  13. Kitano S, Inomata M, Mizusawa J, et al. Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol. 2017;2(4):261–8.

    Article  Google Scholar 

  14. Fujita S, Akasu T, Mizusawa J, et al. Postoperative morbidity and mortality after mesorectal excision with and without lateral lymph node dissection for clinical stage II or stage III lower rectal cancer (JCOG0212): results from a multicentre, randomised controlled, non-inferiority trial. Lancet Oncol. 2012;13(6):616–21.

    Article  Google Scholar 

  15. Yamamoto S, Ito M, Okuda J, et al. Laparoscopic surgery for stage 0/I rectal carcinoma: short-term outcomes of a single-arm phase II trial. Ann Surg. 2013;258(2):283–8.

    Article  Google Scholar 

  16. McCahill LE, Yothers G, Sharif S, et al. Primary mFOLFOX6 plus bevacizumab without resection of the primary tumor for patients presenting with surgically unresectable metastatic colon cancer and an intact asymptomatic colon cancer: definitive analysis of NSABP trial C-10. J Clin Oncol. 2012;30(26):3223–8.

    Article  CAS  Google Scholar 

  17. Modest DP, Heinemann V, Folprecht G, et al. Factors that influence conversion to resectability and survival after resection of metastases in RAS WT metastatic colorectal cancer (mCRC): analysis of FIRE-3- AIOKRK0306. Ann Surg Oncol. 2020;27(7):2389–401.

    Article  Google Scholar 

  18. Biondo S, Frago R, Kreisler E, Espin-Basany E. Impact of resection versus no resection of the primary tumor on survival in patients with colorectal cancer and synchronous unresectable metastases: protocol for a randomized multicenter study (CR4). Int J Colorectal Dis. 2017;32(7):1085–90.

    Article  Google Scholar 

  19. Park EJ, Baek JH, Choi GS, et al. The role of primary tumor resection in colorectal cancer patients with asymptomatic, synchronous, unresectable metastasis: a multicenter randomized controlled trial. Cancers (Basel). 2020;12(8):2306.

    Article  Google Scholar 

  20. Rahbari NN, Lordick F, Fink C, et al. Resection of the primary tumour versus no resection prior to systemic therapy in patients with colon cancer and synchronous unresectable metastases (UICC stage IV): SYNCHRONOUS–a randomised controlled multicentre trial (ISRCTN30964555). BMC Cancer. 2012;12:142.

    Article  Google Scholar 

  21. t Lam-Boer J, Mol L, Verhoef C, et al. The CAIRO4 study: the role of surgery of the primary tumour with few or absent symptoms in patients with synchronous unresectable metastases of colorectal cancer: a randomized phase III study of the Dutch Colorectal Cancer Group (DCCG). BMC Cancer. 2014;14:741.

    Article  Google Scholar 

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Correspondence to Tsuyoshi Konishi MD, PhD.

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Konishi, T., Rodriguez-Bigas, M.A. Primary Tumor Resection in Colorectal Cancer with Unresectable Synchronous Metastasis: Time to Reconsider the Role of the Surgeon. Ann Surg Oncol 29, 1–3 (2022). https://doi.org/10.1245/s10434-021-10949-4

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  • DOI: https://doi.org/10.1245/s10434-021-10949-4

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