Response of the primary tumor in symptomatic and asymptomatic stage IV colorectal cancer to combined interventional endoscopy and palliative chemotherapyReportar como inadecuado

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BMC Cancer

, 9:218

First Online: 01 July 2009Received: 12 September 2008Accepted: 01 July 2009DOI: 10.1186-1471-2407-9-218

Cite this article as: Cameron, S., Hünerbein, D., Mansuroglu, T. et al. BMC Cancer 2009 9: 218. doi:10.1186-1471-2407-9-218


BackgroundThe treatment of the primary tumor in advanced metastatic colorectal cancer CRC is still a matter of discussion. Little attention has thus far been paid to the endoscopically observable changes of the primary in non-curatively resectable stage IV disease.

Methods20 patients 14 men, 6 women, median age 67 39–82 years were observed after initial diagnosis of non-curatively resectable metastasized symptomatic 83% or asymptomatic 17% CRC, from June 2002 to April 2009. If necessary, endoscopic tumor debulking was performed. 5-FU based chemotherapy was given immediately thereafter. In 10 patients, chemotherapy was combined with antibody therapy.

ResultsResponse of the primary was observed in all patients. Local symptoms were treated endoscopically whenever necessary obstruction or bleeding, and further improved after chemotherapy was started: Four patients showed initial complete endoscopic disappearance of the primary. In an additional 6 patients, only adenomatous tissue was histologically detected. In both these groups, two patients revealed local tumor relapse after interruption of therapy. Local tumor regression or stable disease was achieved in the remaining 10 patients. 15 patients died during the observation time. In 13 cases, death was related to metastatic disease progression. The mean overall survival time was 19.6 3–71 months. No complications due to the primary were observed.

ConclusionThis study shows that modern anti-cancer drugs combined with endoscopic therapy are an effective and safe treatment of the symptomatic primary and ameliorate local complaints without the need for surgical intervention in advanced UICC stage IV CRC.

AbbreviationsCEAcarcinoembryonic antigen

CRCcolorectal cancer

ECOGEastern Cooperative Oncology Group Performance Status

OSoverall survival


Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-9-218 contains supplementary material, which is available to authorized users.

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Autor: Silke Cameron - Diana Hünerbein - Tümen Mansuroglu - Thomas Armbrust - Jens-Gerd Scharf - Harald Schwörer - László Fü


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