Surgery in colorectal patients may be unnecessary; efficacy of other GI cancer treatments discussed
MONDAY, June 1 (HealthDay News) -- In patients with synchronous stage IV colorectal cancer who receive up-front modern combination chemotherapy, immediate colon surgery to remove the primary tumor is seldom necessary, according to research presented at the annual meeting of the American Society of Clinical Oncology, held from May 29 to June 2 in Orlando, Fla. These findings accompanied several other studies presented at the conference focusing on treatment of gastrointestinal cancers.
George A. Poultsides, M.D., of Johns Hopkins Hospital in Baltimore, and colleagues retrospectively studied 233 patients who received initial treatment with combination chemotherapy. The researchers found that surgical palliation of the primary tumor was never necessary in 93 percent of the patients. Only 7 percent needed urgent surgery to treat an obstruction or perforation, and only 4 percent needed a non-surgical treatment such as a stent or radiotherapy.
Other studies presented showed no benefit in adding bevacizumab (Avastin) or oxaliplatin (Eloxatin) to standard adjuvant chemotherapy in improving disease-free survival in patients with locally advanced colon cancer and tumor response in locally advanced rectal cancer, respectively. Another study found that gemcitabine (Gemzar) and 5-fluorouracil/folinic acid (5-FU/FA), two commonly used adjuvant treatments for pancreatic cancer, led to similar survival outcomes, but that gemcitabine had fewer side effects.
"These large, conclusive trials tell us what works, and importantly, tell us what doesn't work," said Nicholas Petrelli, M.D., medical director of the Helen F. Graham Cancer Center in Wilmington, Del., and moderator of the press briefing. "Some settle long-time debates in the field, others demonstrate that the current standard of care is actually superior to experimental treatments, and others will allow patients to avoid unnecessary side effects or surgery."
Pharmaceutical relationship disclosures were made for the majority of author participants.
Abstract - Surgery (Colon Cancer)
Abstract - Bevacizumab (Colon Cancer)
Abstract - Oxaliplatin (Rectal Cancer)
Abstract - Gemcitabine (Pancreatic Cancer)