Risk factors for the requirement of surgical or endoscopic interventions during chemotherapy in patients with uncomplicated colorectal cancer and unresectable synchronous metastases.

Background and Objectives The purpose of this study was to determine the risk factors for requirement of surgical or endoscopic interventions for complications caused by the primary tumor during chemotherapy in patients with unresectable metastatic colorectal cancer. Methods A total of 259 patients were diagnosed with uncomplicated colorectal cancer with unresectable metastatic disease and underwent chemotherapy as an initial treatment. Among them, 57 (22.0%) patients underwent palliative interventions because of complications caused by the primary tumor during chemotherapy, including bypass surgery or diverting enterostomy for 22 patients, insertion of colonic stent for 22, and resection of primary tumor for 13. Results Multivariate analysis revealed that rectal lesion (RR, 2.132; 95% CI, 1.080–4.210; P = 0.029) and tumor size larger than 5 cm (RR = 3.644, 95% CI = 1.923–6.902; P < 0.001) were significant risk factors for requirement of palliative intervention. Patients who had none of the risk factors showed better overall survival than those who had one or more (P = 0.021). Conclusions Tumor location in rectum and tumor size larger than 5 cm were significant risk factors for the requirement of surgical or endoscopic interventions during chemotherapy for complications caused by the primary tumor in patients with unresectable metastatic colorectal cancer. J. Surg. Oncol. 2014 110:839–844. © 2014 Wiley Periodicals, Inc.