caa a22 4500 445334746 CHVBK 20180317142750.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1951-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1951-5 Prognostic Value of Resection of Primary Tumor in Patients with Stage IV Colorectal Cancer: Retrospective Analysis of Two Randomized Studies and a Review of the Literature [Elektronische Daten] [Sabine Venderbosch, Johannes de Wilt, Steven Teerenstra, Olaf Loosveld, Aart van Bochove, Harm Sinnige, Geert-Jan Creemers, Margot Tesselaar, Linda Mol, Cornelis Punt, Miriam Koopman] Background: In patients with metastatic colorectal cancer (mCRC) with an asymptomatic primary tumor, there is no consensus on the indication for resection of the primary tumor. Methods: A retrospective analysis was performed on the outcome of stage IV colorectal cancer (CRC) patients with or without resection of the primary tumor treated in the phase III CAIRO and CAIRO2 studies. A review of the literature was performed. Results: In the CAIRO and CAIRO2 studies, 258 and 289 patients had undergone a primary tumor resection and 141 and 159 patients had not, respectively. In the CAIRO study, a significantly better median overall survival and progression-free survival was observed for the resection compared to the nonresection group, with 16.7 vs. 11.4months [P<0.0001, hazard ratio (HR) 0.61], and 6.7 vs. 5.9months (P=0.004; HR 0.74), respectively. In the CAIRO2 study, median overall survival and progression-free survival were also significantly better for the resection compared to the nonresection group, with 20.7 vs. 13.4months (P<0.0001; HR 0.65) and 10.5 vs. 7.8months (P=0.014; HR 0.78), respectively. These differences remained significant in multivariate analyses. Our review identified 22 nonrandomized studies, most of which showed improved survival for mCRC patients who underwent resection of the primary tumor. Conclusions: Our results as well as data from literature indicate that resection of the primary tumor is a prognostic factor for survival in stage IV CRC patients. The potential bias of these results warrants prospective studies on the value of resection of primary tumor in this setting; such studies are currently being planned. The Author(s), 2011 Venderbosch Sabine Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut de Wilt Johannes Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut Teerenstra Steven Department of Clinical Epidemiology, Radboud University Nijmegen Medical Centre, Biostatistics and Health Technology Assessment, Nijmegen, The Netherlands aut Loosveld Olaf Amphia Hospital, Breda, The Netherlands aut van Bochove Aart Zaans Medical Centre, Zaanstad, The Netherlands aut Sinnige Harm Jeroen Bosch Medical Centre, Den Bosch, The Netherlands aut Creemers Geert-Jan Catharina Hospital Eindhoven, Eindhoven, The Netherlands aut Tesselaar Margot Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands aut Mol Linda Comprehensive Cancer Centre, Nijmegen, The Netherlands aut Punt Cornelis Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut Koopman Miriam Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3252-3260 1068-9265 18:12<3252 2011 18 10434 https://doi.org/10.1245/s10434-011-1951-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1951-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Venderbosch Sabine Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- de Wilt Johannes Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Teerenstra Steven Department of Clinical Epidemiology, Radboud University Nijmegen Medical Centre, Biostatistics and Health Technology Assessment, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Loosveld Olaf Amphia Hospital, Breda, The Netherlands aut NATIONALLICENCE 700 1- van Bochove Aart Zaans Medical Centre, Zaanstad, The Netherlands aut NATIONALLICENCE 700 1- Sinnige Harm Jeroen Bosch Medical Centre, Den Bosch, The Netherlands aut NATIONALLICENCE 700 1- Creemers Geert-Jan Catharina Hospital Eindhoven, Eindhoven, The Netherlands aut NATIONALLICENCE 700 1- Tesselaar Margot Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- Mol Linda Comprehensive Cancer Centre, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Punt Cornelis Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Koopman Miriam Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3252-3260 1068-9265 18:12<3252 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer