Local tumor complications in stage IV colorectal cancer

Abstract

Colorectal cancer is associated with distant metastases in 19–26% of patients at initial presentation. Local tumor complications such as obstruction, perforation, and hemorrhage may be identified at initial presentation or may develop during treatment for those that were initially asymptomatic. Optimal management in these situations is dependent on rapid recognition and assessment of the patient's clinical condition, a thorough understanding of oncologic principles, and a multidisciplinary approach to treatment. Given the the reliance on systemic therapy for the management of metastatic disease, it is essential to minimize potential morbidity and mortality to avoid unnecessary treatment delays in this subset of patients. This review highlights the most common local tumor complications seen in the setting of stage IV colorectal cancer and approaches to each.