March 16, 2026 · JAMA · DOI: 10.1001/jama.2026.1929

Tumor Debulking in Combination With Chemotherapy in Multiorgan Metastatic Colorectal Cancer: The ORCHESTRA Randomized Clinical Trial

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The authors aimed to determine whether tumor debulking, when combined with palliative chemotherapy, improves overall survival in patients with multiorgan metastatic colorectal cancer (mCRC). The ORCHESTRA trial found that adding tumor debulking did not significantly enhance overall survival compared to chemotherapy alone, and it was associated with a higher rate of serious adverse events. Consequently, the authors concluded that tumor debulking should not be considered standard care for this patient population.

Elske C Gootjes, Lotte Bakkerus, Anviti A Adhin, Barbara M Zonderhuis, Kathelijn S Versteeg, Jurriaan B Tuynman, Martijn R Meijerink, Cornelis J A Haasbeek, Johannes H W de Wilt, Dirk J Grunhagen, Ewoud J Smit, John M Primrose, John Bridgewater, Esther van Meerten, Jan-Willem B de Groot, Mathijs P Hendriks, Esther Oomen-de Hoop, Tineke E Buffart, Cornelis Verhoef, Henk M W Verheul, ORCHESTRA Study Group

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