Metastatic colorectal cancer--what about the primary?

BACKGROUND Approximately 25% of patients with colorectal cancer present synchronous metastases, most frequently located in the liver. AIMS The assessment of optimal therapeutic strategies for the primary tumor in such patients. METHODS We analyzed the outcomes of 209 patients who underwent simultaneous or delayed resection of the primary tumor and liver metastases, the survival rates of patients with initially unresectable liver metastases that were rendered resectable, and the prognostic factors related to the primary tumor. RESULTS The outcomes of simultaneous resections were similar to those of delayed resection. In patients with initially unresectable liver metastases that were rendered resectable, the survival rates were similar to those of patients with initially resectable metastases. The survival rate of N2 patients was significantly lower than those of N1 and N0 patients. CONCLUSIONS Simultaneous resection provides a safety profile and survival rate similar to that of delayed resection. The N category allows for prognostic estimation in metastatic colorectal patients.