Ann Coloproctol.  2019 Dec;35(6):327-334. 10.3393/ac.2019.03.04.1.

Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients

Affiliations
  • 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. namkyuk@yuhs.ac
  • 2Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
  • 3Department of Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
  • 4Department of Surgery, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Korea.

Abstract

PURPOSE
Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.
METHODS
Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.
RESULTS
There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).
CONCLUSION
There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

Keyword

Colonic neoplasms; Neoplasm metastasis; Antineoplastic agents; Postoperative complications

MeSH Terms

Antineoplastic Agents
Colon*
Colonic Neoplasms*
Drug Therapy*
Humans
Methods
Neoplasm Metastasis
Patient Selection
Postoperative Complications
Antineoplastic Agents
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