Annals of Surgical Oncology

, Volume 14, Issue 9, pp 2567–2576 | Cite as

Palliative Resection of Colorectal Cancer: Does It Prolong Survival?

  • Renato Costi
  • Antonio Mazzeo
  • Davide Di Mauro
  • Licia Veronesi
  • Giuliano Sansebastiano
  • Vincenzo Violi
  • Luigi Roncoroni
  • Leopoldo Sarli
Article

Abstract

Background

It is still a matter of debate as to whether resective surgery of the primary tumor may prolong the survival of patients affected by incurable colorectal cancer (CRC). The main goal of this retrospective study, carried out on patients not undergoing any therapy other than surgery, was to quantify the benefit of primary tumor removal in patients with differently presenting incurable CRC.

Methods

One hundred and thirty consecutive patients were operated on for incurable CRC (83 undergoing resective and 47 non-resective procedures). With the purpose of comparing homogenous populations and of identifying patients who may benefit from primary tumor resection, the patients were classified according to classes of disease, based on the “metastatic pattern” and the “resectability of primary tumor.”

Results

In patients with “resectable” primary tumors, resective procedures are associated with longer median survival than after non-resective ones (9 months vs 3). Only patients with distant spread without neoplastic ascites/carcinosis benefit from primary tumor removal (median survival: 9 months vs 3). Morbidity and mortality of resective procedures is not significantly different from that of non-resective surgery, either in the population studied or in any of the groups considered.

Conclusions

Palliative resection of primary CRC should be pursued in patients with unresectable distant metastasis (without carcinomatosis), and, intraoperatively, whenever the primary tumor is technically resectable.

Keywords

Palliative resection Colorectal cancer Primary tumor Carcinosis Metastasis 

Notes

Acknowledgment

The authors wish to acknowledge Nathalie Bataille, MD, Thierry Montariol, MD, (Service de Chirurgie Viscérale, Hôpital de St.-Germain-en-Laye, France) and Michaël Azagury, MD (Service de Cancerologie, Hôpital de St.-Germain-en-Laye, France) for their contribution in the reviewing process of the article. The authors acknowledge The University of Parma for financial support (Research Funds).

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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Renato Costi
    • 1
    • 2
  • Antonio Mazzeo
    • 1
  • Davide Di Mauro
    • 1
  • Licia Veronesi
    • 3
  • Giuliano Sansebastiano
    • 3
  • Vincenzo Violi
    • 1
  • Luigi Roncoroni
    • 1
  • Leopoldo Sarli
    • 1
  1. 1.Dipartimento di Scienze ChirurgicheUniversità di ParmaParmaItalia
  2. 2.Service Chirurgie ViscéraleCHI de Poissy/ St.-Germain-En-LayeSt.-Germain-En-LayeFrance
  3. 3.Dipartimento di Sanità PubblicaUniversità di ParmaParmaItalia

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