Elective palliative resection of incurable stage IV colorectal cancer: Who really benefits from it?

• DOI: 10.1007/s00595-009-4253-9
• Publication Date: 2011-01-25T02:38:10Z
• Authors: Renato Costi; Davide Di Mauro; Licia Veronesi; Andrea Ardizzoni; Pierfranco Salcuni; Luigi Roncoroni; Leopoldo Sarli; Vincenzo Violi
• Keywords: Surgical oncology; Contraindication; Primary tumor

Despite the encouraging results of chemotherapy in patients affected by incurable colorectal cancer (CRC), surgical resection of a primitive tumor is still a common approach worldwide. The identification of prognostic factors related to short survival (<6 months) may allow excluding from resective surgery those who may not benefit from it.A retrospective analysis was performed of 15 variables in a population of 71 patients undergoing nonemergency palliative primary resections of incurable CRC, including patients' demographics and clinical/histopathological characteristics of the tumor.No variables were related to perioperative mortality (8.5% overall). A multivariate analysis revealed that older age (≥80 years) and metastasis to more than 25% of the lymph nodes were associated with survival (4 and 6 months, respectively). Mucoid adenocarcinoma therefore tends to be associated with the prognosis (P = 0.070).An elderly age tends to be a contraindication to an elective primary tumor resection in patients affected by incurable CRC. Massive lymph node involvement and mucoid adenocarcinoma should also be considered before planning major colonic surgery.