Treatment sequencing for simultaneous colorectal liver metastases.

Up to 25% of patients with colorectal cancer present with simultaneous metastases and the liver is frequently the only metastatic site. This review will review treatment sequence planning considerations-including metastatic burden, primary tumor site, chemotherapy response, and ability to perform minimally invasive surgery-for patients with simultaneous resectable colorectal liver metastases. In addition, this review will address conversion chemotherapy, combined vs staged surgeries, and their possible sequences.