Background: The optimal management of metastatic colorectal cancer (mCRC) involves a multimodality approach. Complete resection of limited metastatic disease is a critical intervention as it is potentially curative. There is currently very limited data on resection rates and outcomes in routine clinical practice.

Methods: Analysis of patients prospectively entered onto the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database, a clinician-designed initiative to collect comprehensive data on consecutive patients with mCRC from sites across Australia. Data collection commenced in July 2009 and is ongoing at 14 participating centres.

Results: At a median follow-up of 20 months, 152 (18%) of 844 enrolled patients have undergone metastasectomy. Further patients treated with curative intent are yet to have resection data recorded. For 18 (11.8%) of the resected patients the initial treatment intent had been palliative.

Compared to unresected patients, those who had resections were younger (median age 62.8 vs 69.5 years, p<0.0001), of better performance status (PS0-1: 97.4 vs 75.7%, p<0.0001), lower Charlson comorbidity score (Charlson<3: 79.6 vs 55.9%, p<0.0001) and more likely to have a single metastatic site (79.6 vs 53.5%, p<0.0001). Private patients were more likely to undergo resections than public patients (23.9% vs 11.2%, p<0.0001).

Conclusion: A substantial proportion of mCRC patients in routine practice undergo resection of distant metastatic disease, including a minority initially treated with palliative intent. As expected, resection rate is higher in younger and fitter patients, and those with more limited disease. The greater proportion of private patients undergoing resection may relate to differences in patient population and/or a more aggressive treatment approach¹. A multivariate analysis and comparison of survival outcomes for the two treatment settings is planned.