Multiple operations for recurrent colorectal cancer

The benefit of an aggressive surgical approach in selective patients with recurrent colorectal cancer has been demonstrated by several investigators. The disease-free 5 year survival is 30%, and in carefully selected series it is as high as 46%. These procedures can be performed safely with minimal morbidity and mortality by surgeons who are experienced in the techniques of radical surgery. It is important and should be our focus to try to identify those patients who will benefit the most from an aggressive surgical approach, by better definition of the biology of the tumor through tumor differentiation and DNA and oncogene analysis.