Staging Stage IV Colorectal Cancer

Excerpt

Like most malignancies, colorectal cancer is an extraordinarily heterogeneous disease. From surgically curable early-stage tumors to almost uniformly lethal diffuse metastatic disease, the treatment and outcome of colorectal cancer runs a wide spectrum. Unlike most malignancies, this spectrum of treatment and outcome exists within the group of patients diagnosed with stage IV disease. Patients who have widely disseminated, multiorgan, metastatic disease are treated with palliative chemotherapy with a median survival of approximately 2 years.1 To add further complexity and heterogeneity to this, up to 10 % of patients treated with palliative chemotherapy survive 5 years, and the group of patients with resected liver and/or lung metastases have an associated 5-year survival rate of ~50 %.2,3 By contrast, ~1 in 5 patients who have limited and resectable liver metastases is cured by hepatic resection.4 Both early death and prolonged disease-free survival are therefore possible in patients with “stage IV” colorectal cancer. …