AIM:To investigate survival in patients treated with FOLFOX followed by primary site resection or palliative surgery for incurable metastatic colorectal cancer. METHODS:Between 2001 and 2009,a total of 98 patients with colorectal adenocarcinoma and non-resectable metastases were diagnosed and treated with the new systemic agent chemotherapy regimen FOLFOX. Primary site resection was carried out in 38 patients, creation of a colostomy or bypass without resection was carried out in 36 patients,and 23 were not operated on because of advanced disease.The survival times of patients in different groups were analyzed. RESULTS:There were no differences between the patients regarding their general condition,concurrent disease,or tumor stage according to AJCC classification.The median survivals of the three groups were 30.6,20.8,and 12.7 mo(log-rank P value<0.05),respectively.The postoperative complication rate was higher in the primary site resection group than in the palliative surgery group. CONCLUSION:The results indicate that there are benefits from primary site resection for incurable metastatic colorectal cancer with systemic chemotherapy. AIM: To investigate survival in patients treated with FOLFOX followed by primary site resection or palliative surgery for incurable metastatic colorectal cancer. METHODS: Between 2001 and 2009, a total of 98 patients with colorectal adenocarcinoma and non-resectable metastases were diagnosed and treated with the new systemic agent chemotherapy regimen FOLFOX. Primary site resection was carried out in 38 patients, creation of a colostomy or bypass without resection was carried out in 36 patients, and 23 were not operated on because of advanced disease. The survival times of patients in different groups were analyzed. RESULTS: There were no differences between the patients regarding their general condition, concurrent disease, or tumor stage according to AJCC classification. median of these survivals of the three groups were 30.6, 20.8, and 12.7 mo (log-rank P value <0.05), respectively.The postoperative complication rate was higher in the primary site resection group than in the palliative surgery group. CONCLUSION: The results indicate that there are benefits from primary site resection for incurable metastatic colorectal cancer with systemic chemotherapy.