Surgery for primary and metastatic colorectal cancer

Carcinoma of the colon and rectum currently ranks as the second leading cause of death from cancer in the United States. Surgery remains the cornerstone of treatment for colorectal cancer but has inherent limitations imposed by the biology and stage of the tumor and its location. Ultimately, 50% of patients who undergo curative resection develop local, regional, or widespread recurrence. These statistics have remained relatively constant over several decades despite improved methods of early diagnosis and surgical treatment but may change as new multimodality treatment regimens are developed and clinically evaluated. This article summarizes the surgical management of colorectal cancer and discusses issues pertaining to postoperative surveillance and the diagnosis and management of local or widespread cancer recurrence.