Colorectal Cancer – Management of Metastatic Disease

Abstract

Metastases from colon cancer occur to the regional lymph nodes, the liver and the peritoneal surfaces. Rectal cancer may disseminate to these sites and also to the lungs. These metastases may occur synchronously with the detection of primary disease or metachronously in follow-up. The timing of the metastatic process is important in terms of treatment possibilities. Each anatomical site for metastatic disease has the potential for an individualised management strategy. Systemic chemotherapy as an adequate management plan for all sites of colorectal metastatic disease is not compatible with a high standard of care. Formulation of an optimal plan combining surgery with regional and systemic chemotherapy is a necessary function of the multidisciplinary team.