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Initial surgery for patients with metastatic colon cancer is clearly warranted when the primary tumor is bleeding or obstructing. However, for patients with asymptomatic tumors and metastases not amenable to curative resection, results from retrospective, phase 2, and phase 3 trials have varied, with some supporting and others questioning a survival benefit for upfront surgery. Investigators now report combined results from the SYNCHRONOUS and CCRe-IV randomized trials comparing upfront primary tumor resection (PTR) followed by chemotherapy to treatment with chemotherapy alone in patients with colon cancer and metastatic disease not curable with surgery.
Of the 393 patients, 95% had liver metastases. Primary tumors were left-sided in 53% of …