Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical Outcomes of Upfront Primary Tumor Resection in Synchronous Unresectable Metastatic Colorectal Cancer

Ji Eun Shin
,
Ho Jung An
* ,
Byoung Yong Shim
ORCID logo ,
Hyunho Kim
,
Hyung Soon Park
,
Hyeon-Min Cho
,
Bong-Hyeon Kye
ORCID logo ,
Ri Na Yoo
ORCID logo ,
Ji-Yeon Moon
ORCID logo ,
Sung Hwan Kim
,
Jonghoon Lee
,
Hyo Chun Lee
,
Ji-Han Jung
,
Kang-Moon Lee
,
Ji Min Lee
Version 1 : Received: 17 August 2023 / Approved: 17 August 2023 / Online: 18 August 2023 (07:25:39 CEST)

A peer-reviewed article of this Preprint also exists.

Shin, J.E.; An, H.J.; Shim, B.Y.; Kim, H.; Park, H.S.; Cho, H.-M.; Kye, B.-H.; Yoo, R.N.; Moon, J.-Y.; Kim, S.H.; Lee, J.; Lee, H.C.; Jung, J.-H.; Lee, K.-M.; Lee, J.M. Clinical Outcomes of Upfront Primary Tumor Resection in Synchronous Unresectable Metastatic Colorectal Cancer. Cancers 2023, 15, 5057. Shin, J.E.; An, H.J.; Shim, B.Y.; Kim, H.; Park, H.S.; Cho, H.-M.; Kye, B.-H.; Yoo, R.N.; Moon, J.-Y.; Kim, S.H.; Lee, J.; Lee, H.C.; Jung, J.-H.; Lee, K.-M.; Lee, J.M. Clinical Outcomes of Upfront Primary Tumor Resection in Synchronous Unresectable Metastatic Colorectal Cancer. Cancers 2023, 15, 5057.

Abstract

The role of upfront primary tumor resection (PTR) in patients with unresectable metastatic col-orectal cancer (CRC) without severe symptoms remains controversial. We retrospectively ana-lyzed the role of PTR in overall survival (OS) in different subgroups. Among 331 patients diag-nosed with synchronous metastatic CRC between 2010 and 2020, 223 were analyzed. The PTR group (n = 42) showed better performance (p = 0.038); higher frequencies of right-sided origin (p = 0.014), T4 stage (p = 0.005), M1a stage (p = 0.015), and <2 organ metastases (p = 0.002); and re-ceived fewer targeted agents (p < 0.001) than the chemotherapy group (n = 181). The PTR group showed longer OS (20.5 versus 14.0 months, p = 0.016), but PTR was marginally related to OS in multivariate analysis (p = 0.060). Male sex (p = 0.022), good performance status (p = 0.07), left-sided tumor (p = 0.069), low serum carcinoembryonic antigen level (p = 0.092), T3 stage (p = 0.029), M1a stage (p = 0.025), <2 organ metastases (p = 0.017), and administration of targeted agents, especially bevacizumab (p = 0.024), were related to survival benefit after PTR. Upfront PTR should be considered when selecting patients with favorable prognoses for bevacizumab administration.

Keywords

colorectal cancer; primary tumor resection; synchronous; metastasis; asymptomatic

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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