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article imageSurgery may not be best first approach to colorectal cancer

By KJ Mullins     May 30, 2009 in Health
Researchers are saying that patients with Stage VI colorectal cancer may benefit more from chemotherapy than from surgical removal of the tumors.
When a patient has been diagnosed with Stage VI colorectal cancer the colon tumor has spread to another organ. If the tumors are not presenting with problems to the patient it may be best to move straight into chemotherapy without delay because of surgical complications.
The study focused on 233 metastatic colorectal cancer cases at Memorial Sloan-Kettering Cancer Center (MSKCC). The researchers found that 90 percent of the cases did not require surgery.
The patients all were given a standard three-drug chemotherapy combination. In folow-up exams 217 of the patients did not require surgery for the primary tumor.
55 had elective surgery on the original tumor and removal of other lesions. Eight had a hepatic-artery infusion-pump implanted. That device pumps the chemotherapy medications directly into the liver.
In the past surgery was the first option and then chemotherapy. The rationale was that the tumors would not respond well to the chemotherapy on the primary tumors.
Doctors now have better medicines to use for chemotheraphy. They believe that the chemotherapy approach is better at reducing the size of colon tumors and the metastases.
Science Daily reports:
"We now know that the routine use of surgery for these patients is based on old thinking, and we're beyond that. There will always be the need for individual exceptions based on the clinical situation, but our default position should be not to operate," said Dr. Paty.
Researchers at the University of Texas M.D. Anderson Cancer Center has found that the survival period from Stage VI colorectal cancer has increased from eight months (patients diagnosed prior to 1990) to more than 30 months. Those diagnosed after 2004 have a 30 percent chance of a five-year survival.
UPI reports:
"In this study, we wanted to determine if these changes resulted in longer survival of metastatic colorectal cancer patients in a large population base," Kopetz, the study's corresponding author, said in a statement.
"There had been some hints -- for example, in Phase III trials we had seen the overall survival increase over several years. However, because of the enormity of the data, the large population data bases are slow to reflect these changes, so there had not been a signal of increased survival."
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