Decision-making: what tests to do? What choices to consider?

The treatment of recurrent colorectal cancer confronts the surgeon with a diagnostic and therapeutic challenge, particularly in cases involving the pelvis. Investigation and treatment in each case is tailored to the individual patient. Treatment is divided into those cases where an attempt at cure is possible and those where only palliation of symptoms is possible. This article seeks to help the surgeon confronted with this problem answer the following questions: Which patients with recurrent colorectal cancer are suitable for consideration of curative resection? What is the extent of disease recurrence? Is the disease resectable? The aim of this article is to offer advice in the logical and appropriate investigation and treatment of patients considered for curative or palliative therapy.