Background: Reports about the influence of curative and palliative tumor resection on metabolism and resting energy expenditure (REE) in colorectal carcinoma are controversial. This study deals with a group of patients with colorectal cancer of all tumor stages undergoing surgery for the primary. Special attention was attributed to the question whether perioperative changes of REE and body composition depend on tumor stage. Patients and Methods: In a prospective study 32 colorectal cancer patients undergoing surgery were investigated in order to compare nutritional status, body composition and metabolism according to tumor stage. In 18 patients with UICC tumor stages I-III the tumors could be completely removed and in 14 patients with stage IV there was persisting tumor mass as liver metastases after resection of the primary. 10 days pre- and post-operatively bioelectrical body impedance analysis (B.I.A.), indirect calori-metry as well as serum and urine analysis were performed. Results: According to tumor stages no significant inter-group difference was observed in body mass index and preoperative weight loss. Significant increase of extracellular/body cell mass ratio indicating an increase of extracellular mass and decrease of body cell mass was preoperatively found in patients with metastatic colorectal cancer. Correlation between the percentage of preoperative weight loss and extracellular/body cell mass ratio was found in patients with tumor stages I-III. Preoperatively, resting energy expenditure, substrate oxidation rates, serum albumin and trans-ferrin as well as urine 3-methylhistidine excretion were without significant differences between the two groups. After resection of the primary no shift towards hypermetabolism was found in patients with unresected metastases compared to those with complete tumor removal. Taking into account the effects of the surgical trauma itself, postoperatively a further increase of extracellular mass and decrease of body cell mass was observed. These changes led to significantly higher ratios of extracellular/body cell mass and resting energy expenditure/body cell mass in patients with metastatic disease. Resting energy expenditure, substrate oxidation rates, serum albumin and transferrin and urine 3-methylhistidine excretion did not reveal significant inter-group differences postoperatively. Conclusion: No difference in body mass index, resting energy expenditure, protein oxidation and 3-methylhistidine urinary excretion can be found in patients with colorectal cancer without and with liver metastases before and after resection of the primary. However, there are indicators for a perioperative higher decrease of body cell mass in patients with liver metastases and palliative resection of the primary. This might be partially attributed to peripheral protein mobilization and protein retention and synthesis by the tumor itself.