Technical surgical considerations for CEA directed second-look operations and hepatic tumor excision

Surgical removal of recurrent metastatic colon and rectal cancer has provided many individuals with disease-free and treatment-free long-term survival of 5 or more years. Surgical removal of metastatic tumor from both lobes of the liver can be done with limited mortality and minimal complications when lesions are small and discovered early. Second-look operations should be performed when a persistently rising carcinoembryonic antigen is observed in the period after colorectal cancer resection, even when all other tests are negative. Repeat operations may be beneficial when all detectable disease was removed at the previous operation.