Common Colorectal Cancer Treatment Not Linked to Better Health Outcomes

Internal Medicine World Report, April 2015,

Researchers from The University of Texas MD Anderson Cancer Center reported a vast improvement in survival rates despite a decrease in primary tumor resection (PTR) to treat stage IV colorectal cancer (CRC).

Researchers from The University of Texas MD Anderson Cancer Center reported a vast improvement in survival rates despite a decrease in primary tumor resection (PTR) to treat stage IV colorectal cancer (CRC).

Their study, published in the March issue of JAMA Surgery, underscored the possible overuse of PTR, a procedure aimed at controlling bleeding, perforation, and obstruction in patients with inoperative stage IV CRC.

Assessing the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, investigators identified 64,157 individuals who were diagnosed with stage IV colon or rectal cancer from Jan. 1, 1988, through Dec. 31, 2010. In addition to weighing patients’ health outcomes, the team determined whether there was a change in the rate of PTR surgeries performed.

With 43&thinsp;273 (67.4%) patients undergoing PTR, the authors deduced there was a significant decrease in the use of PTRs going from 74.5% in 1988 to 57.4% in 2010 (P&thinsp;<&thinsp;.001). Moreover, the team noted there was a considerable drop off in PTR procedures from 1998-2001 and 2001-2010 (—0.41% vs. –2.39%; P&thinsp;<&thinsp;.001)

The authors also found people under 50, females, who were married, had elevated tumor grades, and had colon tumors were more likely to get the surgery.

While PTR use had decreased, survival rates improved with a 8.6% and 17.8% survival rates in 1988 and 2009, respectively (P&thinsp;<&thinsp;.001). The authors determined “the annual percentage change was 2.18% in 1988-2001 and 5.43% in 1996-2009 (P&thinsp;<&thinsp;.001).”

With CRC being the third leading cause of cancer-related deaths, the investigators cited evidence that PTR use has gone down as systemic chemotherapy has been phased in.

“Despite the decreasing primary tumor resection rate, patient survival rates improved,” the authors wrote. “However, primary tumor resection may still be overused, and current treatment practices lag behind evidence-based treatment guidelines.”