Shin Ji Eun, An Ho Jung, Shim Byoung Yong, Kim Hyunho, Park Hyung Soon, Cho Hyeon-Min, Kye Bong-Hyeon, Yoo Ri Na, Moon Ji-Yeon, Kim Sung Hwan, Lee Jonghoon, Lee Hyo Chun, Jung Ji-Han, Lee Kang-Moon, Lee Ji Min
Division of Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea.
Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea.
Cancers (Basel). 2023 Oct 19;15(20):5057. doi: 10.3390/cancers15205057.
The role of upfront primary tumor resection (PTR) in patients with unresectable metastatic colorectal cancer without severe symptoms remains controversial. We retrospectively analyzed the role of PTR in overall survival (OS) in this population. Among the 205 patients who enrolled, the PTR group (n = 42) showed better performance ( = 0.061), had higher frequencies of right-sided origin ( = 0.058), the T4 stage ( = 0.003), the M1a stage ( = 0.012), and <2 organ metastases ( = 0.002), and received fewer targeted agents ( = 0.011) than the chemotherapy group (n = 163). The PTR group showed a trend for longer OS (20.5 versus 16.0 months, = 0.064) but was not related to OS in Cox regression multivariate analysis ( = 0.220). The male sex ( = 0.061), a good performance status ( = 0.078), the T3 stage ( = 0.060), the M1a stage ( = 0.042), <2 organ metastases ( = 0.035), an RAS wild tumor ( = 0.054), and the administration of targeted agents ( = 0.037), especially bevacizumab ( = 0.067), seemed to be related to PTR benefits. Upfront PTR could be considered beneficial in some subgroups, but these findings require larger studies to verify.
对于无症状的不可切除转移性结直肠癌患者， upfront 原发性肿瘤切除术（PTR）的作用仍存在争议。我们回顾性分析了PTR在该人群总生存期（OS）中的作用。在纳入的205例患者中，PTR组（n = 42）表现更好（= 0.061），右侧原发肿瘤的频率更高（= 0.058），T4期（= 0.003），M1a期（= 0.012），以及<2个器官转移（= 0.002），并且与化疗组（n = 163）相比接受靶向药物治疗的较少（= 0.011）。PTR组显示出总生存期延长的趋势（20.5个月对16.0个月，= 0.064），但在Cox回归多因素分析中与总生存期无关（= 0.220）。男性（= 0.061）、良好的体能状态（= 0.078）、T3期（= 0.060）、M1a期（= 0.042）、<2个器官转移（= 0.035）、RAS野生型肿瘤（= 0.054）以及靶向药物的使用（= 0.037），尤其是贝伐单抗（= 0.067），似乎与PTR的益处相关。 upfront PTR在某些亚组中可能被认为是有益的，但这些发现需要更大规模的研究来验证。
