Commentary: Colonoscopic Findings and Tumor Site Do Not Predict Bowel Obstruction During Medical Treatment of Stage IV Colon Cancer

作者: Nevena Damjanov

DOI: 10.1634/THEONCOLOGIST.2009-0084

关键词: Combination chemotherapySurgeryColorectal cancerBowel obstructionUnresectedMedicineColorectal surgeryPrimary tumorPerioperativeCancer

摘要: Despite the increase in colonoscopic screening, colorectal cancer (CRC) remains second-highest cause of death from United States, with a projected toll 49,960 2009. At time diagnosis, between 20% and 25% patients already have metastases, most them unresectable [1]. Fewer than 10% metastatic will be alive 5 years after dying cancer-related complications; therefore, maximizing survival while minimizing treatment-related complications remain goals treating physicians. In 2009, it is accepted practice to initiate systemic treatment without primary CRC tumor resection disease who do not evidence uncontrolled bleeding, obstruction, or perforation. Those potentially resectable metastases should undergo both either before chemotherapy several cycles combination allowing assessment natural history malignancy. With that approach, possible avoid perioperative morbidity mortality unnecessary surgery, since succumb developing symptoms their unresected lesion. published retrospective analyses [2, 3, 4, 5], bowel obstruction common complication related receiving therapy, occurring 10%–20% patients. addition, cancer, patient at risk gastrointestinal hemorrhage fistula formation. However, resecting its risks. For there 20%–30% postoperative 6, 7] 1%–6% peri-operative 8]. Postoperative are likely postpone administration therapy—therapy has been shown prolong [9]. There no guidelines identifying suffer during therapy. Therefore, an effort guide future therapies, Ballian colleagues postulated site relative size could predict need for [10]. They retrospectively examined exist-

参考文章(9)
Seth A. Rosen, Initial Presentation With Stage IV Colorectal Cancer Archives of Surgery. ,vol. 135, pp. 530- 534 ,(2000) , 10.1001/ARCHSURG.135.5.530
Gennaro Galizia, Eva Lieto, Michele Orditura, Paolo Castellano, Vincenzo Imperatore, Margherita Pinto, Anna Zamboli, First-Line Chemotherapy vs Bowel Tumor Resection Plus Chemotherapy for Patients With Unresectable Synchronous Colorectal Hepatic Metastases Archives of Surgery. ,vol. 143, pp. 352- 358 ,(2008) , 10.1001/ARCHSURG.143.4.352
Charles R. Scoggins, Ingrid M. Meszoely, Charles D. Blanke, R. Daniel Beauchamp, Steven D. Leach, Nonoperative management of primary colorectal cancer in patients with stage IV disease. Annals of Surgical Oncology. ,vol. 6, pp. 651- 657 ,(1999) , 10.1007/S10434-999-0651-X
Li-Jen Kuo, Shuh-Yan Leu, Mei-Ching Liu, James Jer-Min Jian, Skye Hongiun Cheng, Chung-Ming Chen, None, How aggressive should we be in patients with stage iv colorectal cancer? Diseases of the Colon & Rectum. ,vol. 46, pp. 1646- 1652 ,(2003) , 10.1007/BF02660770
NC Tebbutt, AR Norman, D Cunningham, ME Hill, D Tait, J Oates, S Livingston, J Andreyev, Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases Gut. ,vol. 52, pp. 568- 573 ,(2003) , 10.1136/GUT.52.4.568
Axel Grothey, Daniel Sargent, Richard M. Goldberg, Hans-Joachim Schmoll, Survival of Patients With Advanced Colorectal Cancer Improves With the Availability of Fluorouracil-Leucovorin, Irinotecan, and Oxaliplatin in the Course of Treatment Journal of Clinical Oncology. ,vol. 22, pp. 1209- 1214 ,(2004) , 10.1200/JCO.2004.11.037
Leyo Ruo, Christina Gougoutas, Philip B Paty, Jose G Guillem, Alfred M Cohen, W.Douglas Wong, Elective bowel resection for incurable stage IV colorectal cancer: prognostic variables for asymptomatic patients Journal of the American College of Surgeons. ,vol. 196, pp. 722- 728 ,(2003) , 10.1016/S1072-7515(03)00136-4