Contrary to previous reports, primary tumour resection prior to chemotherapy does not appear to confer a survival benefit in people with stage IV colorectal cancer (CRC), according to results from a randomised controlled trial.

In the Japanese phase 3 trial, 165 patients from 38 centres were randomly assigned to chemotherapy alone or primary tumour resection plus chemotherapy (with either mFOLFOX6 – flurouracil, leucovorin, oxaliplatin plus bevacizumab – or CapeOX -capecitabine, oxaliplatin and bevacizumab).

The median age was 65 and about 55% were men, the authors reported in the Journal of Clinical Oncology.

All patients had unresectable stage IV asymptomatic CRC and three or fewer unresectable metastastases mainly in the liver (about 73%) or lungs (about 25%).