First-Line Chemotherapy vs Bowel Tumor Resection Plus Chemotherapy for Patients With Unresectable Synchronous Colorectal Hepatic Metastases

摘要: Hypothesis Bowel resection followed by chemotherapy is a better management strategy than immediate in asymptomatic patients with colorectal cancer and unresectable liver-only metastases at presentation. Design Retrospective study. Setting University hospital. Patients Sixty-five consecutive symptom-free synchronous confined to the liver undergoing bowel tumor plus systemic (42 [resection group]) or first (23 [chemotherapy group]). Main Outcome Measures Long-term survival identification of prognostic indicators outcome. Results In group, mean median overall times were shown be significantly those group ( P  = .03). Performance status, basal serum levels lactic dehydrogenase alkaline phosphatase, percentage involvement, potentially curative tumor, type treatment (resection vs chemotherapy) demonstrated only variables correlated long-term survival. On multivariate analysis, performance extent covariates independently associated rate. The rate metastasis downstaging subsequent hepatic was clearly good limited tumor. Conclusions Achieving complete cure appears mostly result shrinkage metastases. status best option for this purpose.