Matthew R. Dixon

The role of primary tumour resection in patients with stage IV colorectal cancer

Objective  The management of stage IV colorectal cancer is controversial. Resection of the primary tumour to prevent obstruction, bleeding or perforation is the traditional approach, although survival benefit is undetermined. Management consisting of diverting ostomy, enteric bypass, laser recanalization or endoscopic stenting is an alternative to radical resection. The purpose of this study was to determine the role of resection of the primary tumour in patients with stage IV colorectal cancer, with specific attention paid to survival benefit and safety.

Strategies for Palliative Care in Advanced Colorectal Cancer

Palliative care has appropriately been receiving increased attention in recent years. From the surgeon’s standpoint, therapy is considered palliative when resection of all known tumor sites is no longer possible or advisable. Since a cure, as commonly defined, is not possible, the goal of treatment and eventually the success of therapy becomes judged by the control of symptoms and alleviation of suffering. Providing optimal palliative care for the patient with advanced colorectal cancer is a complex and challenging process. The process of providing palliative care may be a departure from the traditional surgical satisfaction derived from the complete excision of a malignancy, but surgeons achieving excellence in palliative care will likely find this a rewarding endeavor.