Primary tumor resection for asymptomatic colorectal cancer with unresectable metastasis: the end of the dilemma.

About 15-30% of the patients with colorectal cancer present with metastatic disease at diagnosis (mcrc). 1 cervantes a adam r roselló s et al. Metastatic colorectal cancer: esmo clinical Practice guideline for diagnosis, treatment and follow-up. Ann oncol. 2023; 34: 10-32https://doi.org/10.1016/j.annonc.2022.10.00 Crossref PubMed Google Scholar stage iv crc includes subgroups of patients amenable for different strategies of treatments. This heterogeneity is related to several factors, from the localization of metastasis, limited to the liver and/or lung, its complete resectability, to their molecular profile. Upfront resection versus no resection of the primary tumor in patients with synchronous metastatic colorectal cancer: the randomized phase 3 CAIRO4 study conducted by the Dutch Colorectal Cancer Group and the Danish Colorectal Cancer GroupAnnals of OncologyPreviewUpfront primary tumor resection (PTR) has been associated with longer overall survival (OS) in patients with synchronous unresectable metastatic colorectal cancer (mCRC) in retrospective analyses. The aim of the CAIRO4 study was to investigate whether the addition of upfront PTR to systemic therapy resulted in a survival benefit in patients with synchronous mCRC without severe symptoms of their primary tumor. Full-Text PDF Open Access