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The Role of Primary Tumor Resection in Colorectal Cancer Patients with Asymptomatic, Synchronous, Unresectable Metastasis: A Multicenter Randomized Controlled Trial

 Eun Jung Park  ;  Jeong-Heum Baek  ;  Gyu-Seog Choi  ;  Won Cheol Park  ;  Chang Sik Yu  ;  Sung-Bum Kang  ;  Byung Soh Min  ;  Jae Hwang Kim  ;  Hyeong Rok Kim  ;  Bong Hwa Lee  ;  Jae Hwan Oh  ;  Seung-Yong Jeong  ;  Minkyu Jung  ;  Joong Bae Ahn  ;  Seung Hyuk Baik 
 CANCERS, Vol.12(8) : 2306, 2020-08 
Journal Title
Issue Date
chemotherapy ; colorectal neoplasm ; neoplasm metastasis ; non-curative resection ; overall survival ; primary tumor resection ; synchronous unresectable metastasis
We aimed to assess the survival benefits of primary tumor resection (PTR) followed by chemotherapy in patients with asymptomatic stage IV colorectal cancer with asymptomatic, synchronous, unresectable metastases compared to those of upfront chemotherapy alone. This was an open-label, prospective, randomized controlled trial (ClnicalTrials.gov Identifier: NCT01978249). From May 2013 to April 2016, 48 patients (PTR, n = 26; upfront chemotherapy, n = 22) diagnosed with asymptomatic colorectal cancer with unresectable metastases in 12 tertiary hospitals were randomized (1:1). The primary endpoint was two-year overall survival. The secondary endpoints were primary tumor-related complications, PTR-related complications, and rate of conversion to resectable status. The two-year cancer-specific survival was significantly higher in the PTR group than in the upfront chemotherapy group (72.3% vs. 47.1%; p = 0.049). However, the two-year overall survival rate was not significantly different between the PTR and upfront chemotherapy groups (69.5% vs. 44.8%, p = 0.058). The primary tumor-related complication rate was 22.7%. The PTR-related complication rate was 19.2%, with a major complication rate of 3.8%. The rates of conversion to resectable status were 15.3% and 18.2% in the PTR and upfront chemotherapy groups. While PTR followed by chemotherapy resulted in better two-year cancer-specific survival than upfront chemotherapy, the improvement in the two-year overall survival was not significant.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
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