- Survival of patients with metastatic colorectal cancer (mCRC) has improved significantly in recent years.
- Management of patients with metastatic rectal cancer (mRC) benefits from multidisciplinary input.
- Operative candidates with resectable metastatic disease should undergo resection of the primary tumor and metastases, and should receive chemotherapy.
- Pelvic irradiation with concurrent 5-fluorouracil (5-FU) prior to resection of the rectal tumor is appropriate in patients with bulky, low-lying primary tumors, limited metastatic disease, and a long life expectancy.
- Patients with unresectable metastases should receive upfront chemotherapy.
- Multiple nonsurgical therapies are available to target unresectable liver metastases.
- A combination of cytotoxic and targeted systemic therapies is used in mCRC and has significantly improved outcomes.
- Patients with widespread disease, poor performance status, or multiple comorbidities may be best managed with comfort-oriented, supportive care.