Last updated on January 2019

The Role of Surgery of the Primary Tumour in Patients With Synchronous Unresectable Metastases of Colorectal Cancer


Brief description of study

The clinical benefit of resection of the primary tumour in patients with synchronous unresectable metastases is not known. In the literature studies usually describe retrospective selected patients with synchronous metastases treated with or without resection of the primary tumour. All these studies are biased in patient selection and there are no prospective randomized studies on this topic. In patients with few or absent symptoms of the primary tumour, arguments both in favour and against initial resection have been presented, and therefore a randomized trial is warranted. Although recent publications suggest that resection of the primary tumour in synchronous metastasized colon cancer patients might not be necessary, this appears to be based on feasibility and not on clinical outcome. Several studies comparing large groups of patients with or without resection of the primary tumour suggest an improved survival when the primary tumour is resected. A potential benefit of resection of the primary tumour is to prevent complications of the primary tumour during chemotherapy treatment or during later stages of the disease. A recent analysis of the CAIRO and CAIRO2 data showed that metastatic colon cancer patients who had a resection of the primary tumour prior to study entry, had an improved survival compared to patients without a resection of the primary tumour. However, these patients were selected after the primary tumour was resected and therefore these results are not corrected for surgical morbidity and mortality. The investigators here propose a randomized trial in order to demonstrate that resection of the primary tumour does improve overall survival.

Clinical Study Identifier: NCT01606098

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Rigshospitalet

Copenhagen, Denmark
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Ziekenhuis Amstelland

Amstelveen, Netherlands
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OLVG

Amsterdam, Netherlands
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VUMC

Amsterdam, Netherlands
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Gelre Ziekenhuis

Apeldoorn, Netherlands
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Bravis ziekenhuis

Bergen op Zoom, Netherlands
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Rode Kruis Ziekenhuis

Beverwijk, Netherlands
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Tergooiziekenhuizen

Blaricum, Netherlands
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Deventer Ziekenhuis

Deventer, Netherlands
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Slingeland Ziekenhuis

Doetinchem, Netherlands
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St Annaziekenhuis

Geldrop, Netherlands
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Martini Ziekenhuis

Groningen, Netherlands
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UMCG

Groningen, Netherlands
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Spaarne Gasthuis

Haarlem, Netherlands
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St Jansdal

Harderwijk, Netherlands
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Spaarne Gasthuis

Hoofddorp, Netherlands
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St Antonius Ziekenhuis

Nieuwegein, Netherlands
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Radboudumc

Nijmegen, Netherlands
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Waterland Ziekenhuis

Purmerend, Netherlands
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Maasstad Ziekenhuis

Rotterdam, Netherlands
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Erasmus MC

Rotterdam, Netherlands
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St Franciscus Gasthuis

Rotterdam, Netherlands
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Vlietland Ziekenhuis

Schiedam, Netherlands
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Flevoziekenhuis

Almere, Netherlands
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Catharina Ziekenhuis

Eindhoven, Netherlands
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Recruitment Status: Open


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