Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

Anwar, Suhail; Peter, Mark; Scott, Nigel

doi:10.1111/j.1463-1318.2011.02817.x

Cited by 59 publications

(43 citation statements)

References 51 publications

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“…Surgical resection is the mainstay of therapy in locoregional and eligible metastatic colorectal cancer (9). Colectomy, low anterior excision, or abdominoperineal resection may be performed through laparoscopic or open surgery for the patients with colorectal cancer (10,11).…”

Section: Contextmentioning

confidence: 99%

An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran

Hoseini¹,

Moaddabshoar²,

Hemati³

et al. 2014

Ann Colorectal Res

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Context:Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to identify the clinical and pathological characteristics, as well as survival rate of colorectal cancer in Iran. Evidence Acquisition: The articles published in PubMed without language and time restrictions were included in this review. Only original clinical articles were included in the review and non-clinical studies, including cellular, molecular, genetics, and animal reports, were excluded. The case reports, letters, reviews, and clinical reports with less than 100 patients were excluded, as well. All the clinical data regarding the patients' demographics, tumor characteristics, and survival rate were collected. Results: A total of 178 studies were identified at the initial step of literature search. After applying the inclusion and exclusion criteria, 27 studies, including 37901 patients were eligible. The mean age of the patients was 57.2 years, and the male-female ratio was 1.38. Colon, rectum, and rectosigmoid junction accounted for 58%, 28%, and 14% of all colorectal primary sites, respectively. Moreover, the average proportion of the patients with stages 0-I, II, III, and IV was 9%, 39%, 36%, and 16%, respectively. Besides, tumor grades 1, 2, and 3 were reported in 52%, 37%, and 11% of the patients, respectively. Adenocarcinoma (96.8%) was the most frequent histological type. The mean and median survival rate was 80.1 and 55.2 months, respectively. Additionally, the average 5-year overall survival rate was 52.5%. Conclusions: In Iran, colorectal cancer tends to manifest at locally advanced stage with poor prognosis. Therefore, public health strategies, such as screening programs, should be planned for early detection of this aggressive neoplasm.

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Section: Contextmentioning

confidence: 99%

An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran

Hoseini¹,

Moaddabshoar²,

Hemati³

et al. 2014

Ann Colorectal Res

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“…Primary resection, however, has been shown to confer a significantly longer overall survival than patients managed only with chemotherapeutics [80]. A recent study by Anwar et al suggests that prognostic factors such as tumor burden and performance status, should dictate the necessity for surgical resection rather than the presence of symptoms [9]. Results of a meta-analysis by Stillwell, Buettner and Ho suggest disabling symptoms that arise from the primary tumor as it progresses, including weight loss, pain, nutritional depletion, and anemia/hemorrhage may be prevented by resection of the primary lesion.…”

Section: Surgical Management Of Primary Tumormentioning

confidence: 99%

“…Despite advances to include more patients into the "curative" resection group, the most common treatment of stage IV CC remains palliative colon resection conducted primarily to prevent complications such as obstruction, perforation and hemorrhage [9,83]. It is suggested that resection of the primary may also confer an overall survival benefit.…”

Section: Surgical Management Of Primary Tumormentioning

confidence: 99%

“…A multivariate analysis by Kim et al compared palliative treatments and found the longest median survival in patients treated with resection + postoperative chemotherapy (14 months) compared with chemotherapy alone (8 months) or resection alone (5 months) [11]. It has, however, been suggested that surgical alteration of the body's immune response may increase tumor growth postoperatively [9]. As these patients are usually more ill than those able to undergo resection with a curative intent, relatively high rates of morbidity (20% -45%) and mortality (5% -8%) have been reported [9].…”

Section: Surgical Management Of Primary Tumormentioning

confidence: 99%

“…Of note, selected patients with initially unresectable disease may become eligible for resection if they achieve a good response to systemic therapy. 75% -90% of stage IV colon cancers are not suitable for curative resection [9] due to tumor-specific (inextirpable primary, multiple metastases) or patient-specific (age, co-morbidities) reasons [10]. These patients may benefit from systemic and local therapy [11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recent Advances in the Management of Stage IV Colon Cancer

Kanthan¹,

Senger²,

Ahmed³

et al. 2012

JCT

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Colon cancer is the second commonest cause of cancer-related death in Canadian men and women, with approximately one-third of patients dying from this disease. One quarter of patients present with metastases initially, and up to half of all colon cancer patients will develop stage IV disease over the course of their life. Despite ongoing advances in the evolution of newer cytotoxic drugs, targeted biological agents and improved metastasectomy techniques, the gain in overall survival in these patients is of low magnitude. This manuscript is a targeted review of the recent advances over the last decade in the management of advanced stage IV colon cancer as available in the published English literature. The two major arms of metastatic colon cancer management that include surgery and systemic chemotherapy and palliative measures as available are discussed. A multi-modality team-based approach involving medical oncologists, surgical oncologists, radiologists, and other health-care providers continues to be critical for ongoing success in the therapeutic management of these patients. Future studies of well-designed prospective, randomized-controlled clinical trials to develop and evaluate newer therapeutic strategies are recommended for continued and improved understanding for optimization of clinical management in advanced colon cancer.

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Breast surgery for metastatic breast cancer

Tosello¹,

Torloni

Mota

et al. 2018

Cochrane Database of Systematic Reviews

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Based on existing evidence from two randomised clinical trials, it is not possible to make definitive conclusions on the benefits and risks of breast surgery associated with systemic treatment for women diagnosed with metastatic breast cancer. Until the ongoing clinical trials are finalised, the decision to perform breast surgery in these women should be individualised and shared between the physician and the patient considering the potential risks, benefits, and costs of each intervention.

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Palliative excisional surgery for primary colorectal cancer in patients with incurable metastatic disease. Is there a survival benefit? A systematic review

Cited by 59 publications

References 51 publications

An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran

An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran

Recent Advances in the Management of Stage IV Colon Cancer

Breast surgery for metastatic breast cancer

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