作者: Nevena Damjanov
DOI: 10.1634/THEONCOLOGIST.2009-0084
关键词: Combination chemotherapy 、 Surgery 、 Colorectal cancer 、 Bowel obstruction 、 Unresected 、 Medicine 、 Colorectal surgery 、 Primary tumor 、 Perioperative 、 Cancer
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-