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KMID : 0371420160910040172
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Annals of Surgical Treatment and Research
2016 Volume.91 No. 4 p.172 ~ p.177
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Palliative resection of a primary tumor in patients with unresectable colorectal cancer: could resection type improve survival?
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Jang Hyun-Seok
Ju Jae-Kyun
Kim Chang-Hyun
Lee Soo-Young
Kim Hyeong-Rok
Kim Young-Jin
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Abstract
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Purpose : The aim of this study was to evaluate the impact of extended resection of primary tumor on survival outcome in unresectable colorectal cancer (UCRC).
Methods : A retrospective analysis was conducted for 190 patients undergoing palliative surgery for UCRC between 1998 and 2007 at a single institution. Variables including demographics, histopathological characteristics of tumors, surgical procedures, and course of the disease were examined.
Results : Kaplan-Meier survival curve indicated a significant increase in survival times in patients undergoing extended resection of the primary tumor (P < 0.001). Multivariate analysis showed that extra-abdominal metastasis (P = 0.03), minimal resection of the primary tumor (P = 0.034), and the absence of multimodality adjuvant therapy (P < 0.001) were significantly associated poor survival outcome. The histological characteristics were significantly associated with survival times. Patients with well to moderate differentiation tumors that were extensively resected had significantly increased survival time (P < 0.001), while those with poor differentiation tumors that were extensively resected did not have increase survival time (P = 0.786).
Conclusion : Extended resection of primary tumors significantly improved overall survival compared to minimal resection, especially in well to moderately differentiated tumors (survival time: extended resection, 27.8 ± 2.80 months; minimal resection, 16.5 ± 2.19 months; P = 0.002).
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KEYWORD
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Colorectal neoplasms, Palliative care, Colorectal surgery
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