[Treatment, follow up and prevention of colorectal carcinoma: strategies and controversies in the year 2005].

Colorectal carcinomas are common, so efficient strategies in their prevention and treatment will significantly lower mortality. Life style changes are an efficient primary prevention, but mass screening of the population can reduce morbidity and mortality even further. Complete resection is the clue to cure in colorectal carcinomas. Total mesorectal excision and laparoscopic operations have been established as effective interventions that may also improve patients' quality of life. Adjuvant therapy reduces recurrence rates and is recommended in stage II and III rectal carcinoma and stage III colon carcinoma. The optimal strategies for adjuvant therapy are currently being redefined. The availability of new drugs has extended the therapeutic options in metastatic disease, improving response rates and overall survival in the palliative situation. Sequential therapies with different drug combinations seem to be the most effective strategy. The operative resection of localized metastases to the liver or lung can cure some patients with metastatic disease.