Colorectal cancer metastases: a surgical perspective

Metastases from colorectal cancer occur to the regional lymph nodes, the liver, the peritoneal surfaces, and lung. These metastases may occur synchronously or metachronously and the timing of the metastatic process is important in terms of treatment possibilities. Each anatomic site for metastatic disease has a unique 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 individualized plan combining surgery with regional chemotherapy and systemic chemotherapy is a necessary function of the multidisciplinary team.