Metastatic rectal cancer

Colorectal cancer is a common malignancy and up to 20 % of patients have metastases at diagnosis and up to 50 % of those with localized disease will suffer a recurrence. The problem of metastatic colorectal cancer is therefore substantial. Most patients with metastatic colorectal cancer are treated with palliative intent where the treatment is aimed at prolonging survival and maintaining the quality of life of patients for as long as possible. There have been major advances in the management of metastatic colorectal cancer in the last decade with the advent of multiple new agents for systemic therapy, both cytotoxic drugs and biological agents such as VEGF and EGFR inhibitors. As a result, the overall survival of patients with metastatic colorectal cancer has improved markedly. Furthermore, biomarkers are assuming a larger role in the management of and allow for more tailored management of individual patients.