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Colorectal SurgeryDiagnostic

Colorectal Cancer Staging Workup (NCCN 2024)

Colorectal Cancer Staging Workup (NCCN 2024): Colorectal Cancer Diagnosed → Baseline Workup → Staging Imaging → Clinical Stage → Localized Disease.

Interactive Decision Tree

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Algorithm Steps

  1. ▶
    Start

    Colorectal Cancer Diagnosed

    Biopsy-proven adenocarcinoma

    1. ●
      Action

      Baseline Workup

      CBC, CMP, CEA, LFTs

      • Complete colonoscopy if not done
      • Pathology review: differentiation, LVI
      1. ●
        Action

        Staging Imaging

        CT chest/abdomen/pelvis with IV contrast

        • Rectal: MRI pelvis for T/N staging
        • Liver MRI if indeterminate lesions
        1. ◆
          Decision

          Clinical Stage

          • Stage I-III (localized)
          • Stage IV (metastatic)
          1. ●
            Action

            Localized Disease

            Proceed to surgical planning

            1. ■
              End

              Surgical Resection

              Oncological resection with adequate margins

          2. ●
            Action

            Metastatic Disease

            MDT discussion required

            1. ■
              End

              Multidisciplinary Review

              Chemo, targeted therapy, resectable mets?

        2. ●
          Action

          Molecular Testing

          MSI/MMR, RAS/BRAF, HER2 (if applicable)

Guideline Source

NCCN Clinical Practice Guidelines in Oncology: Colon/Rectal Cancer

DOI: 10.6004/jnccn.2024.0001View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Staging may change after surgical resection
  • PET-CT utility depends on clinical scenario
  • MSI/MMR testing increasingly important

Applicable Regions

USAUUKEU

AU: Cancer Council Australia guidelines

UK: NICE colorectal cancer guidelines

US: NCCN guidelines standard

Version 1Next review: 2028-01-01

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Frequently Asked Questions

What is the Colorectal Cancer Staging Workup (NCCN 2024)?

The Colorectal Cancer Staging Workup (NCCN 2024) is a diagnostic clinical algorithm for Colorectal Surgery. It provides a structured decision tree to guide clinical decision-making, based on NCCN Clinical Practice Guidelines in Oncology: Colon/Rectal Cancer.

What guideline is the Colorectal Cancer Staging Workup (NCCN 2024) based on?

This algorithm is based on NCCN Clinical Practice Guidelines in Oncology: Colon/Rectal Cancer (DOI: 10.6004/jnccn.2024.0001).

What are the limitations of the Colorectal Cancer Staging Workup (NCCN 2024)?

Known limitations include: Staging may change after surgical resection; PET-CT utility depends on clinical scenario; MSI/MMR testing increasingly important. Individual patient factors may require deviation from these recommendations.

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