文章：

同步不可切除转移性结直肠癌中前期原发肿瘤切除的临床结局

Clinical Outcomes of Upfront Primary Tumor Resection in Synchronous Unresectable Metastatic Colorectal Cancer

原文发布日期：19 October 2023

DOI: 10.3390/cancers15205057

类型: Article

开放获取: 是

英文摘要：

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 (p= 0.061), had higher frequencies of right-sided origin (p= 0.058), the T4 stage (p= 0.003), the M1a stage (p= 0.012), and <2 organ metastases (p= 0.002), and received fewer targeted agents (p= 0.011) than the chemotherapy group (n = 163). The PTR group showed a trend for longer OS (20.5 versus 16.0 months,p= 0.064) but was not related to OS in Cox regression multivariate analysis (p= 0.220). The male sex (p= 0.061), a good performance status (p= 0.078), the T3 stage (p= 0.060), the M1a stage (p= 0.042), <2 organ metastases (p= 0.035), an RAS wild tumor (p= 0.054), and the administration of targeted agents (p= 0.037), especially bevacizumab (p= 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.

摘要翻译： 

对于无严重症状的不可切除转移性结直肠癌患者，前期原发肿瘤切除术（PTR）的作用仍存在争议。本研究回顾性分析了PTR对该人群总生存期（OS）的影响。在纳入的205例患者中，与单纯化疗组（n=163）相比，PTR组（n=42）患者体能状态更佳（p=0.061）、右半结肠起源比例更高（p=0.058）、T4分期比例更高（p=0.003）、M1a分期比例更高（p=0.012）、转移器官少于2个的比例更高（p=0.002），且接受靶向药物治疗更少（p=0.011）。PTR组患者OS呈现延长趋势（20.5个月 vs 16.0个月，p=0.064），但Cox回归多变量分析显示PTR与OS无独立相关性（p=0.220）。男性（p=0.061）、良好体能状态（p=0.078）、T3分期（p=0.060）、M1a分期（p=0.042）、转移器官少于2个（p=0.035）、RAS野生型肿瘤（p=0.054）以及接受靶向药物治疗（p=0.037），特别是贝伐珠单抗治疗（p=0.067），似乎与PTR获益相关。前期PTR可能对某些亚组患者有益，但这些发现需要更大规模研究加以验证。

原文链接：

Clinical Outcomes of Upfront Primary Tumor Resection in Synchronous Unresectable Metastatic Colorectal Cancer