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Primary tumor resection in colorectal cancer with unresectable synchronous metastases: A review

世界胃肠肿瘤学杂志：英文版（电子版） 2014年第6期6卷 156-169页

作者： Louis de Mestier Gilles Manceau Cindy Neuzillet Jean Baptiste Bachet Jean Philippe Spano Reza Kianmanesh Jean Christophe Vaillant olivier bouché Laurent Han-noun Mehdi Karoui Department of Gastroenterology and Digestive Oncology Robert-DebréUniversity Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Digestive and Hepato-Pancreato-Biliary SurgeryUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Depart-ment of Gastroenterology and PancreatologyBeaujon University Hospital Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of GastroenterologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Assistance Publique-Hopitaux de Paris Pitié-Salpêtrière HospitalDepartment of Medical OncologyUniversity Institute of Cancerology(ParisⅥ)Pierre and Marie Curie University Department of Digestive and Endocrine Sur-gery Robert-DebréUniversity Hospital

At the time of diagnosis, 25% of patients with colorectal cancer(CRC) present with synchronous metastases, which are unresectable in the majority of patients. Whether primary tumor resection(PTR) followed by chemotherapy or immediate chemotherapy without PTR is the best therapeutic option in patients with asymptomatic CRC and unresectable metastases is a major issue, although unanswered to date. The aim of this study was to review all published data on whether PTR should be performed in patients with CRC and unresectable synchronous metastases. All aspects of the management of CRC were taken into account, es-pecially prognostic factors in patients with CRC and un-resectable metastases. The impact of PTR on survival and quality of life were reviewed, in addition to the characteristics of patients that could benefit from PTR and the possible underlying mechanisms. The risks of both approaches are reported. As no randomized study has been performed to date, we finally discussed how a therapeutic strategy's trial should be designed to pro-vide answer to this issue.

关键词： Colorectal cancer Colorectal surgery Chemotherapy Colorectal primary tumor Survival Livermetastases

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