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Purpose <p>Few reports have so far compared cases of Stage IV colorectal cancer in which primary tumor resection or stoma creation was performed prior to systemic chemotherapy.</p> Methods <p>We retrospectively reviewed 246 patients with clinical Stage IV colorectal cancer who underwent surgery followed by systemic chemotherapy. The patients were divided into two groups: those who underwent only stoma creation (stoma group, <i>n</i> = 62) and those who underwent primary tumor resection (resection group, <i>n</i> = 164).</p> Results <p>The stoma group had more male patients (stoma group vs. resection group, 74.2% vs. 54.8%; <i>p</i> = 0.009), more comorbidities (88.7% vs. 73.2%, <i>p</i> = 0.012), and more rectal tumors (38.7% vs. 11.0%; <i>p</i> &lt; 0.001); after propensity score matching, no differences were seen, but shorter operation time (110 vs. 174&#xa0;min; <i>p</i> &lt; 0.001), less blood loss (5 vs. 11 mL; <i>p</i> &lt; 0.001), longer hospital stay (19 vs. 14 days; <i>p</i> = 0.003), and a shorter duration from surgery to first chemotherapy (27 vs. 35 days; <i>p</i> &lt; 0.001) were seen in the stoma group, with a better overall survival in the resection group (<i>p</i> = 0.036).</p> Conclusion <p>Primary resection of stage IV colorectal cancer is associated with a better prognosis. However, highly invasive surgery may cause postoperative complications and a poor prognosis; therefore, careful consideration of its appropriateness is necessary.</p>

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The prognostic impact of primary tumor resection or stoma construction followed by systemic chemotherapy for stage IV colorectal cancer: A Japanese, multicenter study

  • 期刊论文

  • 发表日期：

    2026年1月24日

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  • Mariko Yamashita,
  • Keisuke Noda,
  • Tetsuro Tominaga,
  • Yuma Takamura,
  • Hiroki Katayama,
  • Shintaro Hashimoto,
  • Shoko Tei,
  • Rika Ono,
  • Mitsutoshi Ishii,
  • Makoto Hisanaga,
  • Kaido Oishi,
  • Masaaki Moriyama,
  • Fumitake Uchida,
  • Toshio Shiraishi,
  • Masaki Kunizaki,
  • Takashi Nonaka,
  • Keitaro Matsumoto

摘要

Purpose

Few reports have so far compared cases of Stage IV colorectal cancer in which primary tumor resection or stoma creation was performed prior to systemic chemotherapy.

Methods

We retrospectively reviewed 246 patients with clinical Stage IV colorectal cancer who underwent surgery followed by systemic chemotherapy. The patients were divided into two groups: those who underwent only stoma creation (stoma group, n = 62) and those who underwent primary tumor resection (resection group, n = 164).

Results

The stoma group had more male patients (stoma group vs. resection group, 74.2% vs. 54.8%; p = 0.009), more comorbidities (88.7% vs. 73.2%, p = 0.012), and more rectal tumors (38.7% vs. 11.0%; p < 0.001); after propensity score matching, no differences were seen, but shorter operation time (110 vs. 174 min; p < 0.001), less blood loss (5 vs. 11 mL; p < 0.001), longer hospital stay (19 vs. 14 days; p = 0.003), and a shorter duration from surgery to first chemotherapy (27 vs. 35 days; p < 0.001) were seen in the stoma group, with a better overall survival in the resection group (p = 0.036).

Conclusion

Primary resection of stage IV colorectal cancer is associated with a better prognosis. However, highly invasive surgery may cause postoperative complications and a poor prognosis; therefore, careful consideration of its appropriateness is necessary.