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

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    Dutch Colorectal Cancer Group
Updated on 27 January 2021
Dave E vanderKruijssen, MD
Primary Contact
St Annaziekenhuis (3.0 mi away) Contact
+51 other location
renal function
neutrophil count
liver metastasis
folfox regimen
metastatic colon cancer


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.

Condition Colorectal Cancer, Rectal Cancer, Malignant neoplasm of colon, Colon Cancer Screening, Colon cancer; rectal cancer, Primary Tumour, Colon Cancer, colon carcinoma, rectal carcinoma
Treatment Surgery of the primary tumour, Systemic treatment
Clinical Study IdentifierNCT01606098
SponsorDutch Colorectal Cancer Group
Last Modified on27 January 2021

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