Forest plot of OS. Subgroup analyses of OS were performed using patient baseline characteristics. Data cutoff date was November 26, 2019. aOne patient missing in the chemotherapy group. bFour patients missing in the chemotherapy group and three patients missing in the PTR plus chemotherapy group. ALP, alkaline phosphatase; CEA, carcinoembryonic antigen; CRP, C-reactive protein; ECOG PS, Eastern Cooperative Oncology Group performance status; HR, hazard ratio; OS, overall survival; PTR, primary tumor resection.