DITORIAL ectal cancer and synchronous metastases : esection of primary tumor or not ? ancer rectal et métastase synchrones : résection u non de la tumeur primitive ?

Content Provider	Semantic Scholar
Copyright Year	2009
Abstract	— c a b s t c n patients with rectal cancer and synchronous metastais, the value of timing and surgical extend of a resection f the primary tumor has been discussed very controverially in the past. On the one hand, an upfront resection f the primary tumor might prevent local complications ue to tumor progression if occurring under systemic therpy, such as obstruction and bleeding, potentially requiring rgent surgery, a situation which is associated with a worse rognosis due to higher morbidity and mortality; on the ther hand, surgery might delay systemic treatment due o potential postoperative complications, with the risk of umor progression — especially in those patients with high umor load or unfavourable tumor biology. Furthermore, in he past, we have discussed these topics more or less in he light of palliative treatment only with prolongation of urvival at it best, whereas now we have to consider that ome of those patients with rectal cancer and synchronous etastases might have a potential option for ''cure'' by ntegrating all instruments of interdisciplinary management, uch as surgery, radiotherapy and systemic treatment, which ight change our opinion about former more traditional equences and algorithms in this special situation. In his article, Tougeron et al. reported a retrospective nalysis of 96 patients with rectal cancer and synchronous etastases that initially underwent either a surgical resecion of their primary tumor (S), radiotherapy with/without hemotherapy followed by surgery (CRTS), chemoradiotherpy without surgery (CRT) or chemotherapy only (CT). Pelvic ymptoms including obstruction, pelvic pain/tenesmus or ectal bleeding requiring blood transfusions or endocopic treatment were evaluated using patients' reports. n the different treatment groups, the duration of a elvic symptom-free period relative to the overall surival observed was 93% (S), 83.1% (CRTS), 53.0% (CRT) a w i p
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Language	English
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Resource Type	Article