Meta-Analysis Comparing Long-Term Efficacy Of Resection And Non-Resection For Primary Tumor In Patients With Metastatic Colorectal Cancer

BackgroundFor patients with unresectable metastatic colorectal cancer and intestinal obstruction, perforation, or severe hemorrhage, the standard approach is resection of the primary tumor and then systemic chemotherapy. However, resection of the primary tumor in patients with Asymptomatic of the primary tumor remains controversial. The purpose of this study was to evaluate the clinical outcome of surgical resection or non-resection for primary tumor in patients with metastatic colorectal cancer.Patients and MethodsWe conducted a systematic search of the MEDLINE, PubMed, and EMBASE databases for literature published up to 31 May 2014. Studies comparing surgical resection to non-resection of primary tumor in patients with colorectal cancer metastases were selected. Main outcomes were overall survival (OS) at 1,3, and 5 years, and cancer-related complication rates. Odds ratios (ORs) and 95%confidence intervals (CIs) were calculated between the resection and non-resection groups.ResultsEleven retrospective studies involving 2193 patients (surgical resection,1111; non-resection,1082) were eligible for this meta-analysis. Relative to the non-resection group, surgical resection was associated with a significant increase in 3-year OS (OR 2.22; 95%CI 1.49-3.30),2-year OS (OR 2.37; 95%CI 1.77-3.18), and 1-year OS (OR 2.77; 95%CI 2.19-3.50). Cancer-related complications were fewer in the surgical resection group compared with the non-resection group (OR 0.65; 95%CI: 0.53-0.80).ConclusionSurgical resection of primary tumor in patients with colorectal cancer metastases is associated with longer survival, and reduces cancer-related complications.