Current reviews in gastrointestinal, minimally invasive, & endocrine surgery

The Surgical Management of Locoregional and Metastatic Colorectal Cancer Recurrences

Colorectal cancer recurrences pose a significant health risk to the U.S. population. Every year approximately 147,000 cases of colorectal cancer are diagnosed in the United States with 75% of these patients undergoing planned curative resection.¹ Nevertheless, 50% of these resections will ultimately result in a recurrence, either locally or with distant metastases.² In most carcinomas, recurrence represents a failure of curative surgical therapy. Colorectal recurrences, however, offer a unique opportunity for the general surgeon to provide curative surgical therapy in a cohort of these patients. Currently, systemic chemotherapy provides only partial tumor response rates with minimal impact on disease-free survival and recurrence rates. The sites of colorectal cancer recurrence successfully managed with surgical therapy include local recurrences, pulmonary metastases, and hepatic metastases. In this brief review, we will outline the aspects of diagnosis, patient selection, operative technique, and outcomes of surgical resection or ablative therapy at these 3 sites that have allowed surgical therapy to remain the only durable opportunity for prolonged survival in affected patients.