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Primary tumor resection extended survival in unresectable synchronous metastases from CRC
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Patients with unresectable synchronous metastases from colorectal cancer who underwent primary tumor resection demonstrated longer OS than those who did not undergo resection, according to a pooled analysis of results from four randomized trials.
The value of primary tumor resection in patients with unresectable synchronous metastases from colorectal cancer remains controversial, according to background information in the study.
Matthieu Faron, MD, of the department of biostatistics and epidemiology at Institut Gustave Roussy in France, and colleagues pooled results of four first-line chemotherapy trials. They used univariate and multivariate analyses to assess whether primary tumor resection affected OS in this patient population.
The analysis included 810 patients with unresectable synchronous metastases. More than half (59%; n=478) underwent resection of their primary tumor prior to study entry.
Patients in the resection group were more likely to have a colonic primary tumor, normal white blood cell count, and lower baseline carcinoembryonic antigen (CEA) and alkaline phosphatase levels (P<.001 for all).
Multivariate analysis showed patients who underwent primary tumor resection demonstrated longer OS (HR=0.63; 95% CI, 0.53-0.75) than patients who did not undergo resection. Patients with rectal primary tumors and low CEA levels derived an even greater survival benefit from primary resection.
Multivariate analysis also showed primary tumor resection was independently associated with longer PFS (HR=0.82; 95% CI, 0.70-0.95).
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.
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