Metastatic and recurrent cancer of the colon and rectum

Summary Carcinoma of the large intestine may metastasize by a variety of routes. Each of these has some special prognostic significance which must be weighed by the surgeon. Although operations for primary localized carcinoma of the colon can be reasonably standardized, the management of cases in which metastases have already appeared or developed subsequent to resection requires considerable ingenuity and judgment on the part of the surgeon. An understanding of the prognostic significance of the various routes of spread is of practical surgical importance.