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Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice

SIMPLE SUMMARY: Oncology practice in gastrointestinal tumors is moving toward therapeutic algorithms comprising multiple systemic options integrated with loco-regional strategies, such as surgery. This paradigm holds true for metastatic colorectal cancer, as well as upper gastrointestinal neoplasms,...

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Autores principales: Fanotto, Valentina, Salani, Francesca, Vivaldi, Caterina, Scartozzi, Mario, Ribero, Dario, Puzzoni, Marco, Montagnani, Francesco, Leone, Francesco, Vasile, Enrico, Bencivenga, Maria, De Manzoni, Giovanni, Basile, Debora, Fornaro, Lorenzo, Masi, Gianluca, Aprile, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913845/
https://www.ncbi.nlm.nih.gov/pubmed/36765854
http://dx.doi.org/10.3390/cancers15030900
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author Fanotto, Valentina
Salani, Francesca
Vivaldi, Caterina
Scartozzi, Mario
Ribero, Dario
Puzzoni, Marco
Montagnani, Francesco
Leone, Francesco
Vasile, Enrico
Bencivenga, Maria
De Manzoni, Giovanni
Basile, Debora
Fornaro, Lorenzo
Masi, Gianluca
Aprile, Giuseppe
author_facet Fanotto, Valentina
Salani, Francesca
Vivaldi, Caterina
Scartozzi, Mario
Ribero, Dario
Puzzoni, Marco
Montagnani, Francesco
Leone, Francesco
Vasile, Enrico
Bencivenga, Maria
De Manzoni, Giovanni
Basile, Debora
Fornaro, Lorenzo
Masi, Gianluca
Aprile, Giuseppe
author_sort Fanotto, Valentina
collection PubMed
description SIMPLE SUMMARY: Oncology practice in gastrointestinal tumors is moving toward therapeutic algorithms comprising multiple systemic options integrated with loco-regional strategies, such as surgery. This paradigm holds true for metastatic colorectal cancer, as well as upper gastrointestinal neoplasms, where the role of the resection of the primary tumor, with or without the administration of systemic therapies and metastasectomy, has been a matter of debate. In our review paper, we discuss the available randomized and retrospective evidence supporting surgery in the metastatic setting of colorectal, gastric and pancreatic cancers, with the aim to grant the clinicians with an up-to-date state of the art on this subject. ABSTRACT: The management of the primary tumor in metastatic colorectal, gastric and pancreatic cancer patients may be challenging. Indeed, primary tumor progression could be associated with severe symptoms, compromising the quality of life and the feasibility of effective systemic therapy, and might result in life-threatening complications. While retrospective series have suggested that surgery on the primary tumor may confer a survival advantage even in asymptomatic patients, randomized trials seem not to definitively support this hypothesis. We discuss the evidence for and against primary tumor resection for patients with metastatic gastrointestinal (colorectal, gastric and pancreatic) cancers treated with systemic therapies and put in context the pros and cons of the onco-surgical approach in the time of precision oncology. We also evaluate current ongoing trials on this topic, anticipating how these will influence both research and everyday practice.
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spelling pubmed-99138452023-02-11 Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice Fanotto, Valentina Salani, Francesca Vivaldi, Caterina Scartozzi, Mario Ribero, Dario Puzzoni, Marco Montagnani, Francesco Leone, Francesco Vasile, Enrico Bencivenga, Maria De Manzoni, Giovanni Basile, Debora Fornaro, Lorenzo Masi, Gianluca Aprile, Giuseppe Cancers (Basel) Review SIMPLE SUMMARY: Oncology practice in gastrointestinal tumors is moving toward therapeutic algorithms comprising multiple systemic options integrated with loco-regional strategies, such as surgery. This paradigm holds true for metastatic colorectal cancer, as well as upper gastrointestinal neoplasms, where the role of the resection of the primary tumor, with or without the administration of systemic therapies and metastasectomy, has been a matter of debate. In our review paper, we discuss the available randomized and retrospective evidence supporting surgery in the metastatic setting of colorectal, gastric and pancreatic cancers, with the aim to grant the clinicians with an up-to-date state of the art on this subject. ABSTRACT: The management of the primary tumor in metastatic colorectal, gastric and pancreatic cancer patients may be challenging. Indeed, primary tumor progression could be associated with severe symptoms, compromising the quality of life and the feasibility of effective systemic therapy, and might result in life-threatening complications. While retrospective series have suggested that surgery on the primary tumor may confer a survival advantage even in asymptomatic patients, randomized trials seem not to definitively support this hypothesis. We discuss the evidence for and against primary tumor resection for patients with metastatic gastrointestinal (colorectal, gastric and pancreatic) cancers treated with systemic therapies and put in context the pros and cons of the onco-surgical approach in the time of precision oncology. We also evaluate current ongoing trials on this topic, anticipating how these will influence both research and everyday practice. MDPI 2023-01-31 /pmc/articles/PMC9913845/ /pubmed/36765854 http://dx.doi.org/10.3390/cancers15030900 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Fanotto, Valentina
Salani, Francesca
Vivaldi, Caterina
Scartozzi, Mario
Ribero, Dario
Puzzoni, Marco
Montagnani, Francesco
Leone, Francesco
Vasile, Enrico
Bencivenga, Maria
De Manzoni, Giovanni
Basile, Debora
Fornaro, Lorenzo
Masi, Gianluca
Aprile, Giuseppe
Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title_full Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title_fullStr Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title_full_unstemmed Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title_short Primary Tumor Resection for Metastatic Colorectal, Gastric and Pancreatic Cancer Patients: In Search of Scientific Evidence to Inform Clinical Practice
title_sort primary tumor resection for metastatic colorectal, gastric and pancreatic cancer patients: in search of scientific evidence to inform clinical practice
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913845/
https://www.ncbi.nlm.nih.gov/pubmed/36765854
http://dx.doi.org/10.3390/cancers15030900
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