Ann Surg Treat Res.  2016 Oct;91(4):172-177. 10.4174/astr.2016.91.4.172.

Palliative resection of a primary tumor in patients with unresectable colorectal cancer: could resection type improve survival?

• Jang HS
• Ju JK
• Kim CH
• Lee SY
• Kim HR
• Kim YJ

• KMID: 2354324
• DOI: http://doi.org/10.4174/astr.2016.91.4.172

Abstract

PURPOSE
The aim of this study was to evaluate the impact of extended resection of primary tumor on survival outcome in unresectable colorectal cancer (UCRC).
METHODS
A retrospective analysis was conducted for 190 patients undergoing palliative surgery for UCRC between 1998 and 2007 at a single institution. Variables including demographics, histopathological characteristics of tumors, surgical procedures, and course of the disease were examined.
RESULTS
Kaplan-Meier survival curve indicated a significant increase in survival times in patients undergoing extended resection of the primary tumor (P < 0.001). Multivariate analysis showed that extra-abdominal metastasis (P = 0.03), minimal resection of the primary tumor (P = 0.034), and the absence of multimodality adjuvant therapy (P < 0.001) were significantly associated poor survival outcome. The histological characteristics were significantly associated with survival times. Patients with well to moderate differentiation tumors that were extensively resected had significantly increased survival time (P < 0.001), while those with poor differentiation tumors that were extensively resected did not have increase survival time (P = 0.786).
CONCLUSION
Extended resection of primary tumors significantly improved overall survival compared to minimal resection, especially in well to moderately differentiated tumors (survival time: extended resection, 27.8 ± 2.80 months; minimal resection, 16.5 ± 2.19 months; P = 0.002).

Keyword

Colorectal neoplasms; Palliative care; Colorectal surgery

MeSH Terms

Colorectal Neoplasms*
Colorectal Surgery
Demography
Humans
Multivariate Analysis
Neoplasm Metastasis
Palliative Care
Retrospective Studies

Figure

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  Fig. 1 Kaplan-Meier survival curves according to the pattern of treatment modality. (A) Four categorized group according to the extent of resection and adjuvant therapy. (B) Survival curve of patients with extended resection according to adjuvant therapy. (C) Survival curves of patients with adjuvant therapy according to the extent of resection.

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