This Article Full Text (PDF) All Versions of this Article: theoncologist.2009-0022v1 14/10/963    most recent eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Google Scholar Articles by Damjanov, N. Articles by Haller, D. G. PubMed PubMed Citation Articles by Damjanov, N. Articles by Haller, D. G.

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: 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.

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

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.