Sixty-day mortality of patients with metastatic colorectal cancer randomized to systemic treatment vs primary tumor resection followed by systemic treatment. The CAIRO4 phase 3 randomized clinical trial.

This study included 196 patients with metastatic colorectal cancer, and few or no symptoms from the primary. At 60 days, mortality rates were higher in those who had surgery as well as chemotherapy: 3 versus 11 per cent, P=0.03.

Comment: These results are of interest, but the real question is whether additional surgery provides a later benefit.