The preoperative assessment and postoperative surveillance of patients with colon and rectal cancer

Once colorectal cancer is diagnosed, it is essential to implement adequate preoperative staging, to devise a treatment plan that minimizes the risk to the patient, and, once treatment is complete, to monitor the patient for the development of recurrent cancer or the development of a new primary. There are a number of factors that impact on outcome, such as whether the operation is elective or emergent, the patient's age and pre-existing comorbid conditions, and the experience of the operating surgeon. Current prospectively collected data has identified risk factors for adverse outcomes following colectomy and proctectomy for cancer. Although a number of follow-up strategies have been described, the most efficacious,and cost effective intensity of postoperative surveillance has yet to be determined.