Postoperative Oncologic Management of Colorectal Cancer Emergencies

Unplanned surgical procedures in colorectal cancer remain a routine practice issue. Despite national screening plans, up to 30% of CRC present with a mechanistic complication such as a digestive obstruction or a bowel perforation. Following urgent surgeries, those tumors are very likely to require the administration of an active anticancer treatment. To remain effective at the localized tumor stage, the initiation of the adjuvant chemotherapy should not be delayed. Recently, the standard 6-month duration of such chemotherapy course has been strongly challenged. For potentially resectable advanced CRC, the aim of the perioperative chemotherapy is to achieve the best response rate. Several chemotherapy regimens are available in the first lines of treatment, according to the tumor biological characterization and to the patient characteristics. Finally, surgical emergencies might occur as the side effects of systemic treatment for advanced stage CRC. The present book chapter aims at summarizing the oncologic management of CRC in the postoperative setting, according to the type of every clinical situation.