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Palliative Resection of Colorectal Cancer: Does It Prolong Survival?

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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.

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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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Authors and Affiliations

  1. Dipartimento di Scienze Chirurgiche, Università di Parma, Parma, Italia

    Renato Costi MD, PhD, Antonio Mazzeo MD, Davide Di Mauro MD, Vincenzo Violi MD, Luigi Roncoroni MD & Leopoldo Sarli MD

  2. Service Chirurgie Viscérale, CHI de Poissy/ St.-Germain-En-Laye, St.-Germain-En-Laye, France

    Renato Costi MD, PhD

  3. Dipartimento di Sanità Pubblica, Università di Parma, Parma, Italia

    Licia Veronesi MD & Giuliano Sansebastiano BS

Authors
  1. Renato Costi MD, PhD
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  2. Antonio Mazzeo MD
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  3. Davide Di Mauro MD
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  4. Licia Veronesi MD
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  5. Giuliano Sansebastiano BS
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  6. Vincenzo Violi MD
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  7. Luigi Roncoroni MD
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  8. Leopoldo Sarli MD
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Corresponding author

Correspondence to Renato Costi MD, PhD.

Additional information

This paper has not been presented to any society or meeting.

Authors’ Contribution: RC: Ideation, drawing, and drafting of the article; AM: Collection of data, drafting of the article; DD: Collection of data, drafting of the article; LV: Statistical analysis, epidemiological data; GS: Statistical analysis; VV: Important intellectual contribution, field expertise; LR: Supervision, important intellectual contribution; LS: Supervision, important intellectual contribution, final review

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Costi, R., Mazzeo, A., Di Mauro, D. et al. Palliative Resection of Colorectal Cancer: Does It Prolong Survival?. Ann Surg Oncol 14, 2567–2576 (2007). https://doi.org/10.1245/s10434-007-9444-2

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  • DOI: https://doi.org/10.1245/s10434-007-9444-2

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