The Role of Primary Tumor Resection (PTR) in Metastatic Colorectal Cancer

Patients with unresectable metastatic colorectal cancer can either receive systemic chemotherapy as first treatment or have a palliative resection of the primary tumor or endoscopic placement of a self-expanding metallic stent if they present with colonic obstruction. The ongoing dilemma is whether resection of the primary tumor in asymptomatic patients is beneficial. The effectiveness of current systemic treatment regimens on the primary tumor as well as the survival benefit of primary tumor resection in the era of new chemotherapy agents, biologics, and targeted therapy is underreported. No prospective randomized studies have yet been published; nevertheless, based on the available literature, it seems that primary tumor (PTR) can possibly improve short-and long-term outcome in highly selected patients with favorable characteristics, specifically low tumor burden and good performance status.