[ Special series on Colorectal Cancer ]
doi: 10.1186/s40880-016-0120-4
Palliative primary tumor resection provides survival benefits for the patients with metastatic colorectal cancer and low circulating levels of dehydrogenase and carcinoembryonic antigen
Wen-Zhuo He, Yu-Ming Rong, Chang Jiang, Fang-Xin Liao, Chen-Xi Yin, Gui-Fang Guo, Hui-Juan Qiu, Bei Zhang and Liang-Ping Xia
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; VIP Region, Sun Yat-sen University Cancer Center
[Abstract]
Background
It remains controversial whether palliative primary tumor resection (PPTR) can provide survival benefits to the patients with metastatic colorectal cancer (mCRC) who have unresectable metastases. The aim of this study was to evaluate whether PPTR could improve the survival of patients with mCRC.
Methods
We conducted a retrospective study on consecutive mCRC patients with unresectable metastases who were diagnosed at Sun Yat-sen University Cancer Center in Guangzhou, Guangdong, China, between January 2005 and December 2012. Overall survival (OS) and progression-free survival (PFS) after first-line chemotherapy failure were compared between the PPTR and non-PPTR patient groups.
Results
A total of 387 patients were identified, including 254 who underwent PPTR and 133 who did not. The median OS of the PPTR and non-PPTR groups was 20.8 and 14.8 months (P < 0.001), respectively. The median PFS after first-line chemotherapy was 7.3 and 4.8 months (P < 0.001) in the PPTR and non-PPTR groups, respectively. A larger proportion of patients in the PPTR group (219 of 254, 86.2%) showed local progression compared with that of patients in the non-PPTR group (95 of 133, 71.4%; P < 0.001). Only patients with normal lactate dehydrogenase (LDH) levels and with carcinoembryonic antigen (CEA) levels <70 ng/mL benefited from PPTR (median OS, 22.2 months for the PPTR group and 16.2 months for the non-PPTR group; P < 0.001).
Conclusions
For mCRC patients with unresectable metastases, PPTR can improve OS and PFS after first-line chemotherapy and decrease the incidence of new organ involvement. However, PPTR should be recommended only for patients with normal LDH levels and with CEA levels < 70 ng/mL.
Background
It remains controversial whether palliative primary tumor resection (PPTR) can provide survival benefits to the patients with metastatic colorectal cancer (mCRC) who have unresectable metastases. The aim of this study was to evaluate whether PPTR could improve the survival of patients with mCRC.
Methods
We conducted a retrospective study on consecutive mCRC patients with unresectable metastases who were diagnosed at Sun Yat-sen University Cancer Center in Guangzhou, Guangdong, China, between January 2005 and December 2012. Overall survival (OS) and progression-free survival (PFS) after first-line chemotherapy failure were compared between the PPTR and non-PPTR patient groups.
Results
A total of 387 patients were identified, including 254 who underwent PPTR and 133 who did not. The median OS of the PPTR and non-PPTR groups was 20.8 and 14.8 months (P < 0.001), respectively. The median PFS after first-line chemotherapy was 7.3 and 4.8 months (P < 0.001) in the PPTR and non-PPTR groups, respectively. A larger proportion of patients in the PPTR group (219 of 254, 86.2%) showed local progression compared with that of patients in the non-PPTR group (95 of 133, 71.4%; P < 0.001). Only patients with normal lactate dehydrogenase (LDH) levels and with carcinoembryonic antigen (CEA) levels <70 ng/mL benefited from PPTR (median OS, 22.2 months for the PPTR group and 16.2 months for the non-PPTR group; P < 0.001).
Conclusions
For mCRC patients with unresectable metastases, PPTR can improve OS and PFS after first-line chemotherapy and decrease the incidence of new organ involvement. However, PPTR should be recommended only for patients with normal LDH levels and with CEA levels < 70 ng/mL.
Chinese Journal of Cancer 2016, Volume: 35, Issue 9
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Wen-Zhuo He, Yu-Ming Rong, Chang Jiang, Fang-Xin Liao, Chen-Xi Yin, Gui-Fang Guo, Hui-Juan Qiu, Bei Zhang and Liang-Ping Xia. Palliative primary tumor resection provides survival benefits for the patients with metastatic colorectal cancer and low circulating levels of dehydrogenase and carcinoembryonic antigen. Chin J Cancer. 2016, 35:58. doi:10.1186/s40880-016-0120-4
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[ Html full-text / Citation export] (BioMed Central)
[Google Scholar]
[ More articles of the special series on Colorectal Cancer ]
Cite this article
Wen-Zhuo He, Yu-Ming Rong, Chang Jiang, Fang-Xin Liao, Chen-Xi Yin, Gui-Fang Guo, Hui-Juan Qiu, Bei Zhang and Liang-Ping Xia. Palliative primary tumor resection provides survival benefits for the patients with metastatic colorectal cancer and low circulating levels of dehydrogenase and carcinoembryonic antigen. Chin J Cancer. 2016, 35:58. doi:10.1186/s40880-016-0120-4
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