<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
5726622&dopt=Abstract>

J Surg Oncol. 2005 Mar 15;89(4):211-7.

   Stelzner S, Hellmich G, Koch R, Ludwig K.

   Department of General and Abdominal Surgery, Dresden-Friedrichstadt
General Hospital, Teaching Hospital of the Technical University Dresden,
Dresden, Germany. <email munged>

   BACKGROUND: The prognostic impact of primary tumor resection in
patients presenting with unresectable synchronous metastases from
colorectal carcinoma (CRC) is not well established. In the present study,
we analyzed fifteen factors to define the value of primary tumor resection
with regard to prognosis.

PATIENTS AND METHODS: We identified 186 consecutive patients with proven
stage IV CRC from the year 1995 to 2001. Variables were tested for their
relationship to survival in univariate analyses with the Kaplan-Meier
method and the log rank test. Factors that showed a significant impact
were included in a Cox proportional hazards model. The tests were repeated
for 107 patients who had no symptoms from their primary tumor.

RESULTS: Overall there were six independent variables with a relationship
to survival: performance status, ASA-class, CEA level, metastatic load,
extent of primary tumor, and chemotherapy.

In the asymptomatic patients we investigated 13 factors, 3 of which proved
to be independent predictors of survival: performance status, CEA level,
and chemotherapy. Resection of primary tumor was only predictive of
survival if in-hospital mortality was excluded.

CONCLUSION: Resection of the tumor, if possible, is doubtless the best
option for stage IV CRC patients with severe symptoms caused by their
primary tumor.
In asymptomatic patients, chemotherapy is preferable to surgery. (c) 2005
Wiley-Liss, Inc.

PMID: 15726622 [PubMed - indexed for MEDLINE]