Abstract
The CAIRO4 study: The role of surgery of the primary tumour with few or absent symptoms in patients with synchronous unresectable metastases of colorectal cancer—A randomized phase III study of the Dutch Colorectal Cancer Group (DCCG).
Highlights
There is no consensus regarding resection of the primary tumour with few or absent symptoms in patients with synchronous unresectable metastatic colorectal cancer (CRC)
The CAIRO4 study is a multicentre, randomized, phase III study that will assess the benefit of resection of the primary tumour in patients with synchronous metastatic CRC
Patients with synchronous unresectable metastatic colorectal cancer with few or absent symptoms of their primary tumour are randomized 1:1 between systemic treatment without resection of the primary tumour, and resection of the primary tumour followed by systemic treatment
Summary
There is no consensus regarding resection of the primary tumour with few or absent symptoms in patients with synchronous unresectable metastatic colorectal cancer (CRC). We here propose a randomized trial in order to demonstrate that resection of the primary tumour improves overall survival. 20% of patients with CRC present with synchronous metastases (stage IV disease, according to TNM-classification) [2]. With resection of both the primary tumour and all metastases, is an option in some patients, the majority of patients with stage IV disease end up in a palliative setting. Palliative systemic treatment, consisting of cytotoxic chemotherapy and targeted therapy, can lead to a significant benefit in overall survival [4]. Standard of care in the Netherlands in first-line treatment consists of fluoro pyrimidine-based chemotherapy in combination with bevacizumab [5]
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