Clinical Edge

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Resecting primary tumors fails to boost survival in metastatic CRC

Key clinical point: Resecting primary tumors that are not causing symptoms does not prolong survival of unresectable metastatic colorectal cancer.

Major finding: Median overall survival was 25.9 months with primary tumor resection followed by chemotherapy and 26.7 months with chemotherapy alone (hazard ratio for death, 1.10; P = .69).

Study details: A phase 3 randomized controlled trial among 160 patients with untreated stage IV colorectal cancer who had asymptomatic primaries and up to three sites of synchronous unresectable metastases (iPACS trial).

Disclosures: Dr. Kanemitsu disclosed that he receives honoraria from Chugai Pharma, Covidien, Ethicon, and Intuitive Surgical, and that he has a consulting or advisory role with Covidien. The study was funded by a Health and Labor Sciences Research Grant for Clinical Cancer Research. Dr. Booth disclosed that he has no conflicts of interest.


Kanemitsu Y et al. 2020 GI Cancers Symposium. Abstract 7.