Staging and prognosis of colon cancer

Given the impact of preoperative staging on patient prognosis and therapeutic decision-making, intensive research is being conducted in many areas concerning staging techniques and strategies. Outside of distant metastatic disease, the presence of nodal metastases is the most significant prognostic variable for patients. Because 20% to 40% of pathologically node-negative patients will die of recurrent colorectal cancer, an opportunity exists to determine which group of colorectal cancer patients may harbor undetected residual disease or aggressive tumor biology and thus benefit from additional therapy or a more aggressive surveillance program. A major focus of research continues in the precise detection of metastatic regional lymph node disease.