Definition of Stages

This program applies to all patients with colon or rectal cancer treated with curative intent with STAGE II or III disease. The guidelines are intended to be applied to cases where patients are believed to be candidates for further treatments in the event of loco-regional or distant recurrence. While surveillance may provide reassurance to patients and identify recurrent disease amenable to curative interventions, it also creates stress and anxiety for patients, and morbidity secondary to investigations required to confirm a diagnosis and earlier identification of disease that is NOT amenable to cure. It is recommended there is discussion with patients to ensure a full understanding of the benefits and risks of surveillance before submitting themselves to rigorous follow up.

STAGE II

All patients with a malignancy that has invaded through the muscularis propria into pericolic fat or through the serosa with or without invasion into surrounding organs (T3 / T4) without involvement of metastasis to their lymph glands or distant organs.

STAGE III

All individuals, regardless of their tumour stage, with evidence of metastasis in their lymph glands without involvementof distant organs.

The program is NOT intended for patients who have Stage I or Stage IV disease. By definition this includes:

STAGE I

All patients who have cancer that has not invaded through the submucosa (T1) or the muscularis propria (T2)with negative lymph nodes.

STAGE IV

All patients who have cancer that has demonstrated metastasis to distant organs.