Surgical treatment of colorectal cancer: A multidimensional review

Abstract

Colorectal cancer (CRC) is the third most prevalent malignancy worldwide and the second leading cause of cancer-related mortality. Its global incidence increases annually, with most patients diagnosed at advanced stages. Despite substantial advancements in chemotherapy, radiotherapy, immune therapy, and targeted therapy, surgical treatment remains the mainstay for CRC management. Particularly, surgery is most effective for managing early-stage and locally advanced cancers. CRC surgery has evolved from conventional subtractive surgery to modern minimally invasive and precision-based techniques. Additionally, CRC treatment strategies have expanded from a single surgical therapy to a multi-modal integrated system encompassing endoscopic therapy, perioperative therapy, molecular targeted therapy, and immunotherapy. This review elucidates the evolution of CRC surgical treatment, describing its transition from early palliative surgery to radical surgery, and, finally, to functional surgery, minimally invasive surgical techniques, and personalized treatment. It reflects the transformation in CRC treatment from simplistic to complex, from generalized to precise, and from singular to comprehensive techniques, providing a holistic perspective on advancements in CRC surgical treatment.

Keywords: Colorectal cancer; Surgical treatment; Precision therapy; Comprehensive treatment; Multidisciplinary team; Targeted therapy

Core Tip: This review systematically examines how colorectal cancer treatments vary across patient subgroups, exploring the historical progression of surgical interventions, evaluating technical and clinical innovations at each stage, and highlighting future directions to address unmet needs in personalized care.