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Gastrointestinal Cancer

Resection of the Primary Colorectal Cancer Is Not Necessary in Nonobstructed Patients with Metastatic Disease

University of Pennsylvania, Abramson Cancer Center, Philadelphia, Pennsylvania, USA

Key Words. Colorectal neoplasms • Chemotherapy • Colectomy • Review literature

Correspondence: Nevena Damjanov, M.D., University of Pennsylvania, Abramson Cancer Center at Penn Presbyterian Medical Center, 51 North 39th Street, Philadelphia, PA 19104, USA. Telephone: 215-662-9801; Fax: 215-243-3249; e-mail: nevena.damjanov{at}uphs.upenn.edu

Received February 9, 2009; accepted for publication September 10, 2009; first published online in THE ONCOLOGIST Express on October 9, 2009.

Disclosures: Nevena Damjanov: Honoraria: Amgen, Sanofi-Aventis, Genentech, Bristol-Myers Squibb; Jared Weiss: None; Daniel G. Haller: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Asymptomatic patients with metastatic colorectal cancer do not routinely need to undergo resection of the primary tumor. Although several retrospective analyses suggest that patients who undergo resection of the primary tumor live longer, most of these reviewed data prior to the advent of modern polychemotherapy and are subject to considerable bias, as patients who were considered able to undergo surgery likely had better overall prognoses than those who were not. In addition to significant prolongation of overall survival, current combinations of systemic chemotherapeutic agents and targeted agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring colon resection.