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Poultsides GA et al. - In a study to describe the frequency of interventions necessary to palliate the intact primary tumor in pts who present with synchronous, stage IV colorectal cancer (CRC) and who receive up-front modern combination chemotherapy without prophylactic surgery, it appears that most pts with synchronous, stage IV CRC who receive this treatment never require palliative surgery for their intact primary tumor. These data support use of chemotherapy, without routine prophylactic resection, as the appropriate standard practice for pts with neither obstructed nor hemorrhaging primary colorectal tumors in the setting of metastatic disease.

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