Prevention of Metastases in Curative Treatment of Colorectal Cancer

Abstract

The survival of patients with a colorectal cancer has improved slightly in the last decades, probably due to better surgical and postoperative care. The goals in cancer treatment are to reduce the incidence of cancer and prevent recurrence of disease after primary treatment. Reduction of recurrence can be obtained by earlier detection of disease, which enables surgery at an earlier stage, by earlier detection of metastases after surgery, and by appropriate surgical techniques. The treatment of the patient begins at the moment of detection of the tumour and it is questionable whether the final outcome can be influenced at this time. It seems obvious that surgical technique may influence the development of local recurrence, but it is less clear to most surgeons whether surgery also influences the occurrence of distant metastases. Experimental studies show that surgery and perioperative treatment like blood transfusion may have an effect on the growth of metastases. Thus not only operative treatment is important for the postoperative course of the disease, but also perioperative measures.