Management of Stage 4 Colon and Rectal Cancer

Craig A. Reickert, MD, MBA, FACS, FASCRS

This issue of Clinics in Colon and Rectal Surgery will review the complexities in the management of stage 4 colon and rectal cancer. There has been steady progress in the management of advanced colorectal cancer with improvements in overall survival; however, the treatments must be thoughtful, individualized, and focused on collaboration with the team of oncology specialists to provide the best chance for control of the disease, minimizing morbidity, and optimizing quality of life during and after treatment. The authors have attempted to review the current information related to epidemiology, evaluation, medical, and surgical management, and have attempted to look to the future for additional options for the treatment of our patients with advanced colorectal malignancy.

Dr. Ilyas has reviewed current epidemiologic data and the current state of the understanding of the pathophysiology. Drs. Feria and Times discuss the effectiveness of the current recommended treatment of stage 4 colorectal cancer. Drs. Ahmad and Webb discuss the technical interventions for advanced cancer that surgeons may need to use. Dr. Nalamati and Dr. Delahunta have reviewed the management of the isolated lymph node lesions outside of normal resection margins. Drs. Lozano and Itenberg present an excellent discussion of the surgical management of liver metastasis. Dr. Stefanou discusses the coordinated care of lung metastasis. Dr. Shah and Dr. Gangi review the consideration of hyperthermic intraperitoneal chemotherapy for treatment of peritoneal disease. Dr. Asai discusses the considerations in synchronous resections for advanced disease. I am glad to include Dr. Feizpour, Turk, and Mohanty's review of quality of life assessment in treatments of stage 4 disease. Dr. Poggio adds a good discussion of the challenges in disease progression during surveillance and differences from the initial presentation. Finally, Doctors Lloy, Lin, Franko, and Raman discuss some of the evolving trends for new and modified treatments in the future.

It was my pleasure to work with these amazing authors for these topics, and I want to thank the contributing authors for their diligent preparation of these articles for your information, education, and hopefully improved outcomes for all our patients.

Publication History

Article published online:
07 February 2023