How do you manage patients with oligometastatic CRC who have completed 6 months of chemotherapy with favorable response followed by partial hepatectomy, while awaiting resection of the primary tumor?

Approximately 14-25% of colorectal cancer present with synchronous colorectal liver metastatic disease (CRLM). There are three treatment strategies: classic, combined, and reverse. The classic approach is to get the primary tumor resection first then systemic chemotherapy followed by liver metastasectomy. The combined approach is to get combined surgery (primary tumor resection and liver metastasectomy simultaneously) with perioperative chemotherapy. The reverse approach is to get liver metastasectomy 1st followed by systemic chemo then primary tumor resection.

In our institute, most of our patients with oligometastatic CRLM would undergo combined surgery with primary tumor resection and liver metastasectomy simultaneously with perioperativ...