Home Gastroenterology Fewer Surgeries for Patients With Advanced Colorectal Cancer

Fewer Surgeries for Patients With Advanced Colorectal Cancer

Chemotherapy is best treatment, especially for those whose cancer has spread, researcher says

THURSDAY, Jan. 15, 2015 (HealthDay News) — Fewer U.S. colorectal cancer patients who are diagnosed in the final stages of their disease are having what can often be unnecessary surgery to have the primary tumor removed, researchers report. These patients are also living longer even as the surgery becomes less common, although their general prognosis is not good, according to the study published online Jan. 14 in JAMA Surgery.

In the study, researchers examined a database on 64,157 patients diagnosed with stage 4 colorectal cancer between 1988 and 2010. About two-thirds (67.4 percent) of patients underwent removal of the primary tumor, but the procedure became less common over time, dropping from 74.5 percent of cases in 1988 to 57.4 percent of cases in 2010. The researchers analyzed the median relative survival rate of the patients.

The median relative survival rate for the patients — those who underwent the surgery and those who didn’t — increased from 9 percent in 1988 to 18 percent in 2009. The researchers did note that the survival picture may also have brightened because new and better drugs have entered the treatment picture since 1988, including Avastin (bevacizumab), Erbitux (cetuximab) and Xeloda (capecitabine).

The findings reveal “increased recognition that the first-line treatment really is chemotherapy” for stage 4 colorectal cancer patients, study coauthor George Chang, M.D., chief of colon and rectal surgery at the University of Texas MD Anderson Cancer Center in Houston, told HealthDay. While removing the primary tumor may be helpful for some reasons, he said, “surgery is not life-prolonging.”

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