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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (03): 305-310. doi: 10.3877/cma.j.issn.1674-3946.2023.03.019

• Original Article • Previous Articles     Next Articles

A meta-analysis of primary tumor resection in asymptomatic colorectal cancer with unresectable metastases

Chengren Zhang1, Xiongfei Yang2, Binbin Du2,(), Lili Liu3, Jingjing Li2, Chengzhang Zhu2, Dewang Wu2, Yaochun Lv2,()   

  1. 1. Department of Anorectal Surgery,Gansu Provincial People’s Hospital,Lanzhou Gansu Province 730000,China
    2. Clinical Research Center for Anorectal Diseases of Gansu Province,Lanzhou Gansu Province 730000,China
  • Received:2022-12-18 Online:2023-06-26 Published:2023-06-02
  • Contact: Binbin Du, Yaochun Lv
  • Supported by:
    Key Research and Development Program of Science and Technology Department of Gansu Province(22YF7FA097); Science and Technology Development Program of Lanzhou Science and Technology Bureau(2022-5-51); Gansu Clinical Medical Research Center for Anorectal Diseases(20JR10RA434); Scientific Research Fund of Gansu Provincial People’s Hospital(21GSSYC-20, 21GSSYC-21); Foundation of Lanzhou Science and Technology Bureau(2022-ZD-47)

Abstract:

Objective

To evaluate the efficacy of primary tumor resection(PTR)plus chemotherapy versus chemotherapy alone in patients with unresectable asymptomatic colorectal cancer with metastases.

Methods

To search relevant studies published in PubMed,Embase,Web of science,Cochrane Library,CNKI,Wanfang and VIP databases from the establishment of the database to October 2022. Meta analysis of survival data was performed by Review Manager 5.4 and Stata 16.0. HR and its 95% CI were used to evaluate the survival risk of patients,Q test and I2 test were used to evaluate the heterogeneity between studies,sensitivity analysis was used to evaluate the reliability of the results,subgroup analysis was used to find the source of heterogeneity,and Egger's test and funnel plot were used to evaluate publication bias between studies.

Results

A total of 10 studies were included,including 5 randomized controlled trials(RCTS)and 5 retrospective cohort studies(RCS). Meta-analysis showed no significant differences in overall survival(OS)and progression-free survival(PFS)between the two treatments. The results of subgroup analysis also suggested no additional survival benefit from PTR. The results of funnel plot and Egger's test(t=-0.360,P=0.730)showed that there was no significant publication bias in the studies reporting patients' OS.

Conclusions

Compared with chemotherapy alone,PTR plus chemotherapy can not bring more survival benefits to patients. However,due to the limitations of this study,follow-up large-sample randomized controlled trials are still needed for verification.

Key words: Colorectal Neoplasms, Drug Therapy, Primary Tumor, Resection, Meta- Analysis

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