In patients with definitively unresectable colorectal liver metastases,whether the primary tumor should be resected prior to chemotherapy is an old question.Several retrospective studies(1-5)and a meta-analysis with i...In patients with definitively unresectable colorectal liver metastases,whether the primary tumor should be resected prior to chemotherapy is an old question.Several retrospective studies(1-5)and a meta-analysis with individual data(6)had suggested that primary resection of the primary tumor followed by chemotherapy was associated with better survival than the chemotherapy-first strategy.The prevention of complications related to the primary tumor(occlusion,perforation,bleeding)as well as a better response to chemotherapy were usual justifications to explain the superiority of primary tumor resection-first.However,the absence of any randomized study made it difficult to conclude on this question due to the numerous selection biases related to these retrospective analyses.展开更多
文摘In patients with definitively unresectable colorectal liver metastases,whether the primary tumor should be resected prior to chemotherapy is an old question.Several retrospective studies(1-5)and a meta-analysis with individual data(6)had suggested that primary resection of the primary tumor followed by chemotherapy was associated with better survival than the chemotherapy-first strategy.The prevention of complications related to the primary tumor(occlusion,perforation,bleeding)as well as a better response to chemotherapy were usual justifications to explain the superiority of primary tumor resection-first.However,the absence of any randomized study made it difficult to conclude on this question due to the numerous selection biases related to these retrospective analyses.
