دورية أكاديمية

Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies.

التفاصيل البيبلوغرافية
العنوان: Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies.
المؤلفون: Huang, Jun, Zhou, Jiahao, Zhang, Ping, Wu, Qingbin, Wang, Ziqiang
المصدر: Langenbeck's Archives of Surgery; 8/6/2024, Vol. 409 Issue 1, p1-11, 11p
مصطلحات موضوعية: TUMOR surgery, COLORECTAL cancer, RANDOMIZED controlled trials, OVERALL survival, METASTASIS
مستخلص: Purpose: The value of upfront primary tumor resection (PTR) for asymptomatic unresectable metastatic colorectal cancer (mCRC) patients remains contentious. This meta-analysis aimed to assess the prognostic significance of upfront PTR for asymptomatic unresectable mCRC. Methods: A systematic literature search was performed on June 21st, 2024. To minimize the bias and ensure robust evidence, only randomized controlled trials (RCTs) and case-matched studies (CMS) that compared PTR followed by chemotherapy to chemotherapy alone were included. The primary outcome was overall survival (OS), while cancer-specific survival (CSS) served as the secondary outcome. Results: Eight studies (three RCTs and five CMS) involving 1221 patients were included. Compared to chemotherapy alone, upfront PTR followed by chemotherapy did not improve OS (hazard ratios [HR] 0.91, 95% confidence interval [CI] 0.79–1.04, P = 0.17), but was associated with slightly better CSS (HR 0.59, 95% CI 0.40–0.88, P = 0.009). Conclusions: The current limited evidence indicates that upfront PTR does not improve OS but may enhance CSS in asymptomatic unresectable mCRC patients. Ongoing trials are expected to provide more reliable evidence on this issue. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:14352443
DOI:10.1007/s00423-024-03414-9