Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases
Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. Aims: This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative res...
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| Veröffentlicht in: | Gut 2003-04, Vol.52 (4), p.568-573 |
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| creator | Tebbutt, N C Norman, A R Cunningham, D Hill, M E Tait, D Oates, J Livingston, S Andreyev, J |
| description | Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. Aims: This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative resection of the primary tumour. Patients: The incidence of intestinal obstruction, perforation, fistula formation, and gastrointestinal haemorrhage, and the requirement for abdominal radiotherapy in patients with metastatic colorectal cancer treated at a single institution over a 10 year period was determined. Results: Eighty two patients received initial treatment with chemotherapy without resection of the primary tumour (unresected group) and 280 patients had undergone prior resection (resected group). In the unresected group, the incidence of peritonitis, fistula formation, and intestinal haemorrhage was 2.4% (95% confidence interval (CI) 0.3–8.5%), 3.7% (95% CI 0.8–10.3%), and 3.7% (95% CI 0.8–10.3%), respectively, and was not significantly different from the resected group. Intestinal obstruction affected 13.4% (95% CI 6.9–22.7%) of patients in the unresected group and 13.2% (95% CI 9.2–17.2%) of patients in the resected group. More patients in the unresected group required ⩾3 blood transfusions (14.6% v 7.5%; p=0.048) and abdominal radiotherapy (18.3% v 9.6%; p=0.03) than the resected group. Conclusions: The incidence of major intestinal complications in patients with unresected colorectal cancer and synchronous metastases who receive initial treatment with chemotherapy is low. Chemotherapy may be successfully used as initial treatment for such patients with no increased risk of most major intestinal complications compared with patients who have undergone initial resection of the primary tumour. |
| doi_str_mv | 10.1136/gut.52.4.568 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1773619</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A99428723</galeid><sourcerecordid>A99428723</sourcerecordid><originalsourceid>FETCH-LOGICAL-b610t-b4b9782ea8c42f103ed34984ef5c28df1f96069ba2dd044693a0f2983e7923fc3</originalsourceid><addsrcrecordid>eNp9ktuLEzEUxgdR3Lr65rMMivji1NwmlxdhKV5WFkVQEV9Cmkna1JmkJhm1D_7vpnTYrlAkgcA5Pz7O-fJV1UMI5hBi-mI15nmL5mTeUn6rmkFCeYMR57erGQCQNS0j4qy6l9IGAMC5gHerM4gohpTBWfXn0meTsvOqr3UYtr3TKrvgU61sNrHWazOEvDZRbXe1DbHelrbxOdW_XF7Xo48mGZ1NV2-jG1TcFZU-xFLaCyqvi4byXZ12Xq9j8GFM9WCySuWadL-6Y1WfzIPpPa8-v371afG2ufrw5nJxcdUsKQS5WZKlYBwZxTVBFgJsOkwEJ8a2GvHOQisooGKpUNcBQqjAClgkODZMIGw1Pq9eHnS343IwnS4LRNXLaWQZlJP_drxby1X4KSFjmEJRBJ5MAjH8GIthchPGWExLe0RgwABmhXp8oFaqN9J5G4qYHlzS8kIIgjhDuEDPT0Ar44vHffDGulK-iTcn8HI6Mzh9ip_kdQwpRWOvt4RA7gMjS2BkiySRJTAFf3TTmSM8JaQATydAJa16G8ufunTkCIWIcHGc06Vsfl_3VfwuKcOsle-_LOQ73H78-g0yiQr_7MAvh83_R_wLvBzntg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1779307037</pqid></control><display><type>article</type><title>Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Tebbutt, N C ; Norman, A R ; Cunningham, D ; Hill, M E ; Tait, D ; Oates, J ; Livingston, S ; Andreyev, J</creator><creatorcontrib>Tebbutt, N C ; Norman, A R ; Cunningham, D ; Hill, M E ; Tait, D ; Oates, J ; Livingston, S ; Andreyev, J</creatorcontrib><description>Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. Aims: This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative resection of the primary tumour. Patients: The incidence of intestinal obstruction, perforation, fistula formation, and gastrointestinal haemorrhage, and the requirement for abdominal radiotherapy in patients with metastatic colorectal cancer treated at a single institution over a 10 year period was determined. Results: Eighty two patients received initial treatment with chemotherapy without resection of the primary tumour (unresected group) and 280 patients had undergone prior resection (resected group). In the unresected group, the incidence of peritonitis, fistula formation, and intestinal haemorrhage was 2.4% (95% confidence interval (CI) 0.3–8.5%), 3.7% (95% CI 0.8–10.3%), and 3.7% (95% CI 0.8–10.3%), respectively, and was not significantly different from the resected group. Intestinal obstruction affected 13.4% (95% CI 6.9–22.7%) of patients in the unresected group and 13.2% (95% CI 9.2–17.2%) of patients in the resected group. More patients in the unresected group required ⩾3 blood transfusions (14.6% v 7.5%; p=0.048) and abdominal radiotherapy (18.3% v 9.6%; p=0.03) than the resected group. Conclusions: The incidence of major intestinal complications in patients with unresected colorectal cancer and synchronous metastases who receive initial treatment with chemotherapy is low. Chemotherapy may be successfully used as initial treatment for such patients with no increased risk of most major intestinal complications compared with patients who have undergone initial resection of the primary tumour.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>EISSN: 1458-3288</identifier><identifier>DOI: 10.1136/gut.52.4.568</identifier><identifier>PMID: 12631671</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>5- fluorouracil ; 5-FU ; Abdomen ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Biological and medical sciences ; Cancer ; Cancer therapies ; carcinoembryonic antigen ; Care and treatment ; CEA ; Chemotherapy ; Colon ; Colorectal cancer ; Colorectal diseases ; colorectal neoplasm ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - surgery ; Combined Modality Therapy ; Complications and side effects ; computed tomography ; Constipation ; Endoscopy ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal diseases ; Gastrointestinal Hemorrhage - chemically induced ; hazard ratio ; Humans ; intestinal complications ; Intestinal Diseases - chemically induced ; Intestinal Obstruction - chemically induced ; Lasers ; Male ; Medical sciences ; metastases ; Metastasis ; Middle Aged ; Mortality ; Multivariate analysis ; Neoplasm Metastasis ; Palliative Care - methods ; Patients ; Proportional Hazards Models ; Prospective Studies ; Quality of life ; Radiation therapy ; Risk factors ; RMH ; Royal Marsden Hospital ; Statistical analysis ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Survival Analysis ; Tumors ; YAG: neodymium yttrium aluminium garnet</subject><ispartof>Gut, 2003-04, Vol.52 (4), p.568-573</ispartof><rights>Copyright 2003 by Gut</rights><rights>2003 INIST-CNRS</rights><rights>COPYRIGHT 2003 BMJ Publishing Group Ltd.</rights><rights>Copyright: 2003 Copyright 2003 by Gut</rights><rights>Copyright © Copyright 2003 by Gut 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b610t-b4b9782ea8c42f103ed34984ef5c28df1f96069ba2dd044693a0f2983e7923fc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773619/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773619/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14612489$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12631671$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tebbutt, N C</creatorcontrib><creatorcontrib>Norman, A R</creatorcontrib><creatorcontrib>Cunningham, D</creatorcontrib><creatorcontrib>Hill, M E</creatorcontrib><creatorcontrib>Tait, D</creatorcontrib><creatorcontrib>Oates, J</creatorcontrib><creatorcontrib>Livingston, S</creatorcontrib><creatorcontrib>Andreyev, J</creatorcontrib><title>Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases</title><title>Gut</title><addtitle>Gut</addtitle><description>Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. Aims: This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative resection of the primary tumour. Patients: The incidence of intestinal obstruction, perforation, fistula formation, and gastrointestinal haemorrhage, and the requirement for abdominal radiotherapy in patients with metastatic colorectal cancer treated at a single institution over a 10 year period was determined. Results: Eighty two patients received initial treatment with chemotherapy without resection of the primary tumour (unresected group) and 280 patients had undergone prior resection (resected group). In the unresected group, the incidence of peritonitis, fistula formation, and intestinal haemorrhage was 2.4% (95% confidence interval (CI) 0.3–8.5%), 3.7% (95% CI 0.8–10.3%), and 3.7% (95% CI 0.8–10.3%), respectively, and was not significantly different from the resected group. Intestinal obstruction affected 13.4% (95% CI 6.9–22.7%) of patients in the unresected group and 13.2% (95% CI 9.2–17.2%) of patients in the resected group. More patients in the unresected group required ⩾3 blood transfusions (14.6% v 7.5%; p=0.048) and abdominal radiotherapy (18.3% v 9.6%; p=0.03) than the resected group. Conclusions: The incidence of major intestinal complications in patients with unresected colorectal cancer and synchronous metastases who receive initial treatment with chemotherapy is low. Chemotherapy may be successfully used as initial treatment for such patients with no increased risk of most major intestinal complications compared with patients who have undergone initial resection of the primary tumour.</description><subject>5- fluorouracil</subject><subject>5-FU</subject><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>carcinoembryonic antigen</subject><subject>Care and treatment</subject><subject>CEA</subject><subject>Chemotherapy</subject><subject>Colon</subject><subject>Colorectal cancer</subject><subject>Colorectal diseases</subject><subject>colorectal neoplasm</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Combined Modality Therapy</subject><subject>Complications and side effects</subject><subject>computed tomography</subject><subject>Constipation</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal diseases</subject><subject>Gastrointestinal Hemorrhage - chemically induced</subject><subject>hazard ratio</subject><subject>Humans</subject><subject>intestinal complications</subject><subject>Intestinal Diseases - chemically induced</subject><subject>Intestinal Obstruction - chemically induced</subject><subject>Lasers</subject><subject>Male</subject><subject>Medical sciences</subject><subject>metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Neoplasm Metastasis</subject><subject>Palliative Care - methods</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Quality of life</subject><subject>Radiation therapy</subject><subject>Risk factors</subject><subject>RMH</subject><subject>Royal Marsden Hospital</subject><subject>Statistical analysis</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Tumors</subject><subject>YAG: neodymium yttrium aluminium garnet</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1458-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9ktuLEzEUxgdR3Lr65rMMivji1NwmlxdhKV5WFkVQEV9Cmkna1JmkJhm1D_7vpnTYrlAkgcA5Pz7O-fJV1UMI5hBi-mI15nmL5mTeUn6rmkFCeYMR57erGQCQNS0j4qy6l9IGAMC5gHerM4gohpTBWfXn0meTsvOqr3UYtr3TKrvgU61sNrHWazOEvDZRbXe1DbHelrbxOdW_XF7Xo48mGZ1NV2-jG1TcFZU-xFLaCyqvi4byXZ12Xq9j8GFM9WCySuWadL-6Y1WfzIPpPa8-v371afG2ufrw5nJxcdUsKQS5WZKlYBwZxTVBFgJsOkwEJ8a2GvHOQisooGKpUNcBQqjAClgkODZMIGw1Pq9eHnS343IwnS4LRNXLaWQZlJP_drxby1X4KSFjmEJRBJ5MAjH8GIthchPGWExLe0RgwABmhXp8oFaqN9J5G4qYHlzS8kIIgjhDuEDPT0Ar44vHffDGulK-iTcn8HI6Mzh9ip_kdQwpRWOvt4RA7gMjS2BkiySRJTAFf3TTmSM8JaQATydAJa16G8ufunTkCIWIcHGc06Vsfl_3VfwuKcOsle-_LOQ73H78-g0yiQr_7MAvh83_R_wLvBzntg</recordid><startdate>20030401</startdate><enddate>20030401</enddate><creator>Tebbutt, N C</creator><creator>Norman, A R</creator><creator>Cunningham, D</creator><creator>Hill, M E</creator><creator>Tait, D</creator><creator>Oates, J</creator><creator>Livingston, S</creator><creator>Andreyev, J</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>Copyright 2003 by Gut</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>20030401</creationdate><title>Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases</title><author>Tebbutt, N C ; Norman, A R ; Cunningham, D ; Hill, M E ; Tait, D ; Oates, J ; Livingston, S ; Andreyev, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b610t-b4b9782ea8c42f103ed34984ef5c28df1f96069ba2dd044693a0f2983e7923fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>5- fluorouracil</topic><topic>5-FU</topic><topic>Abdomen</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>carcinoembryonic antigen</topic><topic>Care and treatment</topic><topic>CEA</topic><topic>Chemotherapy</topic><topic>Colon</topic><topic>Colorectal cancer</topic><topic>Colorectal diseases</topic><topic>colorectal neoplasm</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Combined Modality Therapy</topic><topic>Complications and side effects</topic><topic>computed tomography</topic><topic>Constipation</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal diseases</topic><topic>Gastrointestinal Hemorrhage - chemically induced</topic><topic>hazard ratio</topic><topic>Humans</topic><topic>intestinal complications</topic><topic>Intestinal Diseases - chemically induced</topic><topic>Intestinal Obstruction - chemically induced</topic><topic>Lasers</topic><topic>Male</topic><topic>Medical sciences</topic><topic>metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Neoplasm Metastasis</topic><topic>Palliative Care - methods</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Quality of life</topic><topic>Radiation therapy</topic><topic>Risk factors</topic><topic>RMH</topic><topic>Royal Marsden Hospital</topic><topic>Statistical analysis</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Tumors</topic><topic>YAG: neodymium yttrium aluminium garnet</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tebbutt, N C</creatorcontrib><creatorcontrib>Norman, A R</creatorcontrib><creatorcontrib>Cunningham, D</creatorcontrib><creatorcontrib>Hill, M E</creatorcontrib><creatorcontrib>Tait, D</creatorcontrib><creatorcontrib>Oates, J</creatorcontrib><creatorcontrib>Livingston, S</creatorcontrib><creatorcontrib>Andreyev, J</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tebbutt, N C</au><au>Norman, A R</au><au>Cunningham, D</au><au>Hill, M E</au><au>Tait, D</au><au>Oates, J</au><au>Livingston, S</au><au>Andreyev, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>2003-04-01</date><risdate>2003</risdate><volume>52</volume><issue>4</issue><spage>568</spage><epage>573</epage><pages>568-573</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><eissn>1458-3288</eissn><coden>GUTTAK</coden><abstract>Background: The role of palliative resection of the primary tumour in patients who present with metastatic colorectal cancer is unclear. Aims: This study compared the incidence of major intestinal complications in such patients who received chemotherapy treatment with or without prior palliative resection of the primary tumour. Patients: The incidence of intestinal obstruction, perforation, fistula formation, and gastrointestinal haemorrhage, and the requirement for abdominal radiotherapy in patients with metastatic colorectal cancer treated at a single institution over a 10 year period was determined. Results: Eighty two patients received initial treatment with chemotherapy without resection of the primary tumour (unresected group) and 280 patients had undergone prior resection (resected group). In the unresected group, the incidence of peritonitis, fistula formation, and intestinal haemorrhage was 2.4% (95% confidence interval (CI) 0.3–8.5%), 3.7% (95% CI 0.8–10.3%), and 3.7% (95% CI 0.8–10.3%), respectively, and was not significantly different from the resected group. Intestinal obstruction affected 13.4% (95% CI 6.9–22.7%) of patients in the unresected group and 13.2% (95% CI 9.2–17.2%) of patients in the resected group. More patients in the unresected group required ⩾3 blood transfusions (14.6% v 7.5%; p=0.048) and abdominal radiotherapy (18.3% v 9.6%; p=0.03) than the resected group. Conclusions: The incidence of major intestinal complications in patients with unresected colorectal cancer and synchronous metastases who receive initial treatment with chemotherapy is low. Chemotherapy may be successfully used as initial treatment for such patients with no increased risk of most major intestinal complications compared with patients who have undergone initial resection of the primary tumour.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>12631671</pmid><doi>10.1136/gut.52.4.568</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 5- fluorouracil 5-FU Abdomen Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - adverse effects Biological and medical sciences Cancer Cancer therapies carcinoembryonic antigen Care and treatment CEA Chemotherapy Colon Colorectal cancer Colorectal diseases colorectal neoplasm Colorectal Neoplasms - drug therapy Colorectal Neoplasms - surgery Combined Modality Therapy Complications and side effects computed tomography Constipation Endoscopy Female Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal diseases Gastrointestinal Hemorrhage - chemically induced hazard ratio Humans intestinal complications Intestinal Diseases - chemically induced Intestinal Obstruction - chemically induced Lasers Male Medical sciences metastases Metastasis Middle Aged Mortality Multivariate analysis Neoplasm Metastasis Palliative Care - methods Patients Proportional Hazards Models Prospective Studies Quality of life Radiation therapy Risk factors RMH Royal Marsden Hospital Statistical analysis Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Survival Analysis Tumors YAG: neodymium yttrium aluminium garnet |
| title | Intestinal complications after chemotherapy for patients with unresected primary colorectal cancer and synchronous metastases |
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