- Resection of the primary tumor was associated with better OS and similar complication rates in patients with incurable colorectal cancer.
Why this matters
- Modest survival improvement suggests primary tumor resection (PTR) should be considered on a case-by-case basis.
- Meta-analysis of 77 studies (n=159,991).
- Funding: None disclosed.
- Mean OS:
- Primary tumor intact (PTI) without chemotherapy, 4.02 months.
- PTR without chemotherapy, 7.42 months.
- PTI and chemotherapy, 14.30 months.
- PTI and chemotherapy with bevacizumab, 17.27 months.
- PTR and chemotherapy, 21.52 months.
- PTR and chemotherapy with bevacizumab, 27.52 months.
- PTR was associated with better OS compared with PTI (mean difference [MD], 7.46 months [P<.0001 hr>
- PTR was also associated with longer cancer-specific survival (HR, 0.44 [P<.0001 md months pfs>
- Perioperative mortality, 4.5%.
- 22.4% morbidity: major adverse events (10.2%), minor adverse events (18.5%), reoperation (2.5%), and intraabdominal collection/sepsis (2.2%).
- 21.7% morbidity.
- Nonresective surgery:
- 10.6% perioperative mortality, 21.7% morbidity.
- Most included studies were retrospective.