The role of surgery for unusual sites of metastases from colorectal cancer: A review of the literature.

Although systemic therapy represents the backbone of metastatic colorectal cancer management, surgical resection in selected patients may lead to improved survival, such as observed for hepatic, pulmonary or peritoneal metastases. In regards to surgery for less frequent sites of metastases, far less data are available. The purpose of this article is to review the literature regarding the role of surgery for unusual sites of metastases from colorectal cancer, specifically adrenal, ovarian, and retroperitoneal sites. There are no randomized data to strongly support surgical approach in these scenarios. Despite that, benefit following surgery was suggested in several retrospective studies, with some reports of long-term survival. A careful selection of patients is certainly the key to obtaining better outcomes. Potential characteristics suggesting greater benefit from metastasectomy are isolated site of metastasis, longer disease-free interval from previous treatment, complete resectability, and good performance status.