Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Primary Tumor Resection Plus Chemotherapy Versus Chemotherapy Alone for Colorectal Cancer Patients With Asymptomatic, Synchronous Unresectable Metastases (JCOG1007; iPACS): A Randomized Clinical Trial.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
101 citing papers in PubMed, 3 syntheses or guidelines pooled it, 191 citations in OpenAlex.
- Primary tumor resection for asymptomatic colorectal cancer patients with synchronous unresectable metastases: a meta-analysis of randomized controlled trials and case-matched studies.Langenbeck's archives of surgery · 2024Pooled it
- The impact of primary tumor resection for asymptomatic colorectal cancer patients with unresectable metastases: a systematic review and meta-analysis.International journal of colorectal disease · 2023Pooled it
- Asymptomatic Primary Tumor Resection in Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2022Pooled it
- Trial
- Efficacy of Bevacizumab and Gemcitabine in Combination with Cisplatin in the Treatment of Esophageal Cancer and the Effect on the Incidence of Adverse Reactions.BioMed research international · 2022Trial
- Raltitrexed Chemotherapy Regimen Plus Bevacizumab as Second-Line Treatment for Metastatic Colorectal Cancer: A Prospective Multicenter Phase II Trial.Cancer control : journal of the Moffitt Cancer CenterTrial
- Association between primary-site surgery and overall survival in non-metastatic and metastatic colorectal cancer: a population-based study using the Surveillance, Epidemiology, and End Results database.Translational cancer research · 2026Article
- Prognostic Role of Pretreatment Nutritional and Inflammatory Status in Unresectable Metastatic Colorectal Cancer: Supplementary Analysis of JCOG1007.Annals of surgical oncology · 2026Article
- Association of Primary Tumor Resection with Survival in De Novo Stage IV Colorectal Cancer: A Retrospective Cohort Study with Propensity Score Matching.Current oncology (Toronto, Ont.) · 2026Article
- Beyond a Metabolite: Lactylation as a Pivotal Regulator of Colorectal Cancer Pathogenesis and Treatment Resistance.Journal of biochemical and molecular toxicology · 2026Review
- A quasi-bridge to surgery approach for stage IV obstructive colon cancer: extending the bridge-to-surgery concept to metastatic disease.World journal of surgical oncology · 2026Article
- Surgical management for symptomatic primary tumors in unresectable stage IV rectal cancers.Surgery today · 2026Article
- Primary Tumor Resection in Patients With Unresectable Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.Annals of gastroenterological surgery · 2026Review
- Outcomes and management of primary tumors in metastatic MSI/dMMR colorectal cancer patients treated with immune checkpoint inhibitors: a cohort study.ESMO gastrointestinal oncology · 2026Article
- Surgical management of small intestinal neuroendocrine tumours.The British journal of surgery · 2026Article
- Combination of Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging and a Serum Biomarker Is Useful in the Diagnosis of Hepatic Sinusoidal Disorder After Chemotherapy Treatment.Annals of gastroenterological surgery · 2026Article
- How to Integrate Surgery into the Multidisciplinary Treatment of Liver-Only Metastatic Colorectal Cancer.Cancers · 2026Review
- Survival impact of radiotherapy for patients with de novo metastatic rectal cancer.Annals of coloproctology · 2026Article
- Chemotherapy After Colonic Stent in Patients With Unresectable Obstructive Colorectal Cancer: A Retrospective Multicenter Observational Study.Endoscopy international open · 2026Article
- Article
41 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
21 authors at 15 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIt remains controversial whether primary tumor resection (PTR) before chemotherapy improves survival in patients with colorectal cancer (CRC) with asymptomatic primary tumor and synchronous unresectable metastases. PATIENTS AND
methodsThis randomized phase III study investigated the superiority of PTR followed by chemotherapy versus chemotherapy alone in relation to overall survival (OS) in patients with unresectable stage IV asymptomatic CRC and three or fewer unresectable metastatic diseases confined to the liver, lungs, distant lymph nodes, or peritoneum. Chemotherapy regimens of either mFOLFOX6 plus bevacizumab or CapeOX plus bevacizumab were decided before study entry. The primary end point was OS, which was analyzed by intention-to-treat.
resultsBetween June 2012 and September 2019, a total of 165 patients were randomly assigned to either chemotherapy alone (84 patients) or PTR plus chemotherapy (81 patients). When the first interim analysis was performed in September 2019 with 50% (114/227) of the expected events observed among 160 patients at the data cutoff date of June 5, 2019, the Data and Safety Monitoring Committee recommended early termination of the trial because of futility. With a median follow-up of 22.0 months, median OS was 25.9 months (95% CI, 19.9 to 31.5) in the PTR plus chemotherapy arm and 26.7 (95% CI, 21.9 to 32.5) in the chemotherapy-alone arm (hazard ratio, 1.10; 95% CI, 0.76 to 1.59; one-sided
conclusionGiven that PTR followed by chemotherapy showed no survival benefit over chemotherapy alone, PTR should no longer be considered a standard of care for patients with CRC with asymptomatic primary tumors and synchronous unresectable metastases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.