Colorectal Cancer with Multiple Metastases: Is Palliative Surgery Needed?
Journal of the Korean Society of Coloproctology
; : 226-230, 2011.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-157257
Biblioteca responsable:
WPRO
ABSTRACT
In patients with symptomatic incurable metastatic colorectal cancer (mCRC), the goal of resection of the primary lesion is to palliate cancer-related morbidity, including obstruction, bleeding, or perforation. In patients with asymptomatic primary tumors and incurable metastatic disease, however, the necessity of primary tumor resection is less clear. Although several retrospective analyses suggest survival benefit in patients who undergo resection of the primary tumor, applying this older evidence to modern patients is out of date for several reasons. Modern chemotherapy regimens incorporating the novel cytotoxic agents oxaliplatin and irinotecan, as well as the target agents bevacizumab and cetuximab, have improved median survival from less than 1 year with the only available single-agent 5-fluorouracil until the mid-1990s to over 2 years. In addition to significant prolongation of overall survival, combinations of novel chemotherapeutic and target agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring surgical resection. Resection of an asymptomatic primary tumor risks surgical complications and may postpone the administration of chemotherapy that may offer both systemic and local control. In conclusion, the morbidity and the mortality of unnecessary surgery or surgery that does not improve quality of life or survival in patients with mCRC of a limited life expectancy should be carefully evaluated. With the availability of effective combinations of chemotherapy and target agents, systemic therapy for the treatment of life-threatening metastases would be a preferable treatment strategy for unresectable asymptomatic patients with mCRC.
Texto completo:
Disponible
Contexto en salud:
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Neoplasias Colorrectales
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Compuestos Organoplatinos
/
Cuidados Paliativos
/
Calidad de Vida
/
Camptotecina
/
Neoplasias Colorrectales
/
Estudios Retrospectivos
/
Esperanza de Vida
/
Procedimientos Innecesarios
/
Citotoxinas
/
Anticuerpos Monoclonales Humanizados
Tipo de estudio:
Estudio observacional
Aspecto:
Preferencia del paciente
Límite:
Humanos
Idioma:
Inglés
Revista:
Journal of the Korean Society of Coloproctology
Año:
2011
Tipo del documento:
Artículo