Table 1.

Diagnostic evaluation of synchronous colorectal cancer

Local tumour staging Preoperative colonoscopy with histological assessment of all colorectal lesions CT of the abdomen and pelvis

In case of rectal cancer include Endorectal ultrasound Pelvic magnetic resonance imaging

If preoperative evaluation during colonoscopy is incomplete (bowel obstruction, poor bowel preparation, technical reasons, etc.) Double-contrast barium enema CT colonography, if available MRI colonography, if available PET–CT colonography, if available

Intraoperative assessment Intraoperative colonoscopy Palpation of the entire colon Thorough examination of pathological specimens

Evaluation of metastatic disease CT of the chest, abdomen, and pelvis MRI of the chest, abdomen, and pelvis, in selected cases 18FDG-PET–CT, in selected cases

Patient performance status Thorough evaluation of coexisting morbidities Pulmonary function tests, in selected cases Echocardiography, in selected cases

CT: Computer tomography; MRI: Magnetic resonance imaging; PET-CT: Positron emission tomography/computer tomography.