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Clinical significance of primary tumor resection in colorectal cancer patients with synchronous unresectable metastasis.

 Min Sung Kim  ;  MinKyu Chung  ;  Joong Bae Ahn  ;  Chang Woo Kim  ;  Min Soo Cho  ;  Sang Joon Shin  ;  Se Jin Baek  ;  Hyuk Hur  ;  Byung Soh Min  ;  Seung Hyuk Baik  ;  Nam Kyu Kim 
 JOURNAL OF SURGICAL ONCOLOGY, Vol.110(2) : 214-221, 2014 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Asymptomatic Diseases ; Camptothecin/analogs & derivatives* ; Camptothecin/therapeutic use ; Chemotherapy, Adjuvant ; Colectomy* ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/surgery* ; Deoxycytidine/analogs & derivatives* ; Deoxycytidine/therapeutic use ; Drug Administration Schedule ; Female ; Fluorouracil/analogs & derivatives* ; Fluorouracil/therapeutic use ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Leucovorin/therapeutic use ; Male ; Middle Aged ; Neoplasm Metastasis ; Organoplatinum Compounds/therapeutic use ; Palliative Care/methods ; Rectum/surgery* ; Retrospective Studies ; Survival Rate ; Treatment Outcome
chemotherapy ; colorectal neoplasm ; primary tumor resection ; synchronous unresectable metastasis
BACKGROUND: The aim of this study was to compare the outcomes in colorectal cancer (CRC) patients with synchronous unresectable metastases who received either primary tumor resection (PTR) or chemotherapy as the first treatment and to investigate the clinical course of asymptomatic patients who received chemotherapy as the first treatment. METHODS: We retrospectively analyzed 324 CRC patients with synchronous unresectable metastases. Overall survival (OS) was analyzed for the two groups (upfront PTR group [n = 72] vs. upfront chemotherapy group [n = 252]). Surgical morbidity and mortality were recorded. In the asymptomatic patients who received upfront chemotherapy, the incidences of primary tumor-related complications were analyzed. RESULTS: In patients who underwent PTR as the first treatment, the median OS period was superior to those who received upfront chemotherapy (17.2 vs. 13.6 months, P = 0.002). In the PTR group, surgical morbidity and mortality were 11.6% and 1.9%, respectively. Of the 252 asymptomatic patients, the incidence of primary tumor-related complications was 35%. Emergent surgery was ultimately done in 14% of the 252 patients. CONCLUSION: CRC patients with synchronous unresectable metastases who underwent PTR followed by chemotherapy had significantly longer survival times compared to patients who received chemotherapy as the first treatment.
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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
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Min Sung(김민성)
Kim, Chang Woo(김창우)
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Baek, Se Jin(백세진)
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
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
Cho, Min Soo(조민수)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
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