[Colorectal carcinoma--surgical interventions in metastases]

Metastases from colorectal cancer should be resected, if surgery can achieve a complete freedom of tumor and if the procedure is associated with a low morbidity and mortality rate. Multiple sites of metastases do not represent a contraindication for surgery, if complete excision appears possible. The resulting 5-year survival rate after resection of pulmonary and liver metastases is in the range of 20-30%, and the survival is influenced by the extent of the distant spread and the stage of the primary tumor.--The aim of neoadjuvant chemotherapy is the improvement of resectability and of postoperative prognosis. Postoperative regional chemotherapy did not show a significant survival benefit for the patient, only the recurrence free survival rate is increased. Due to the complex disease and the necessary technical knowledge the treatment outcome is better in the cooperation of colorectal specialists from surgery, gastroenterology and medical and radiation oncology.