{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:14:03Z","timestamp":1790885643210,"version":"4.1.0"},"reference-count":113,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Colorectal liver metastases (CRLMs) remain a major determinant of long-term outcome. Although hepatic resection offers the best chance of durable survival, the definition of resectability has evolved beyond technical feasibility alone. This review aims to provide a structured overview of contemporary management strategies for patients with upfront technically resectable or synchronous CRLM, with emphasis on patient selection, tumor biology, perioperative systemic therapy, margin strategy, and surgical sequencing. Methods: A structured literature search of PubMed\/MEDLINE, Embase, Scopus, and the Cochrane Library was performed to identify studies published between 2000 and 2026. Eligible studies evaluated surgical, liver-directed, or systemic treatment strategies for CRLMs and reported outcomes including overall survival, disease-free survival, recurrence, margin status, or perioperative morbidity. Given the heterogeneity of the available evidence, findings were synthesized narratively. Results: Contemporary management of CRLMs requires integration of patient fitness, technical resectability, and tumor biology. In upfront technically resectable disease, routine neoadjuvant chemotherapy has not consistently improved overall survival, whereas selected high-risk patients may benefit from short-course preoperative therapy. Margin strategy is increasingly biology-informed rather than based on a universal margin width. In synchronous disease, no single operative sequence is superior for all patients; treatment should be selected according to disease burden, operative complexity, and the need to preserve access to systemic therapy. Conclusions: Management of upfront resectable and synchronous CRLMs should be individualized through multidisciplinary assessment. Current evidence supports a risk-adapted strategy that integrates technical feasibility, patient factors, and tumor biology while recognizing persistent uncertainty regarding optimal chemotherapy timing and surgical sequencing.<\/jats:p>","DOI":"10.3390\/cancers18193165","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:19:08Z","timestamp":1790842748000},"page":"3165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Contemporary Review of Resectability and Treatment Strategies for Colorectal Liver Metastases: Part 1\u2014Diagnosis, Defining Resectability, and Management of Upfront Resectable and Synchronous Disease"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-4690","authenticated-orcid":false,"given":"Jennifer A.","family":"Kalil","sequence":"first","affiliation":[{"name":"Cancer Research Program, Research Institute of the McGill University Health Center (RI-MUHC), Montreal, QC H4A 3J1, Canada"},{"name":"Department of Surgery, McGill University Health Center, Montreal, QC H4A 0B1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2169-5449","authenticated-orcid":false,"given":"Ren\u00e9","family":"Adam","sequence":"additional","affiliation":[{"name":"Henri-Bismuth Hepatobiliary Center, Paul-Brousse Hospital, Assistance Publique-H\u00f4pitaux de Paris, Paris-Saclay University, 94804 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8454-8484","authenticated-orcid":false,"given":"Nicholas","family":"Meti","sequence":"additional","affiliation":[{"name":"Gerald Bronfman Department of Oncology, McGill University Health Center, Montreal, QC H4A 0B1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6191-8136","authenticated-orcid":false,"given":"Peter","family":"Metrakos","sequence":"additional","affiliation":[{"name":"Cancer Research Program, Research Institute of the McGill University Health Center (RI-MUHC), Montreal, QC H4A 3J1, Canada"},{"name":"Department of Surgery, McGill University Health Center, Montreal, QC H4A 0B1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","first-page":"e240029","article-title":"Colon Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology","volume":"22","author":"Benson","year":"2024","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/cam4.2673","article-title":"Metastatic patterns and survival outcomes in patients with stage IV colon cancer: A population-based analysis","volume":"9","author":"Wang","year":"2020","journal-title":"Cancer Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.amjsurg.2016.08.014","article-title":"Outcomes after repeat hepatic resection for recurrent metastatic colorectal cancer: A population-based study","volume":"213","author":"Nanji","year":"2017","journal-title":"Am. J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1245\/s10434-010-1409-1","article-title":"Effect on outcome of recurrence patterns after hepatectomy for colorectal metastases","volume":"18","author":"Kornprat","year":"2011","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3253","DOI":"10.3748\/wjg.v12.i20.3253","article-title":"Evolution in the treatment of metastatic colorectal carcinoma of the liver","volume":"12","author":"Ariyan","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1200\/JCO.2006.09.0928","article-title":"Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: The Gruppo Oncologico Nord Ovest","volume":"25","author":"Falcone","year":"2007","journal-title":"J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1016\/j.ejso.2021.02.019","article-title":"Conversion therapy in patients with colorectal liver metastases","volume":"47","author":"Villard","year":"2021","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ejca.2017.01.010","article-title":"The role of image-guided therapy in the management of colorectal cancer metastatic disease","volume":"75","author":"Tselikas","year":"2017","journal-title":"Eur. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"w20390","DOI":"10.4414\/smw.2021.20390","article-title":"Multimodal treatment strategies for colorectal liver metastases","volume":"151","author":"Birrer","year":"2021","journal-title":"Swiss Med. Wkly."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1002\/ags3.12276","article-title":"How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective","volume":"3","author":"Imai","year":"2019","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/j.surg.2021.06.033","article-title":"The evolution of surgery for colorectal liver metastases: A persistent challenge to improve survival","volume":"170","author":"Kambakamba","year":"2021","journal-title":"Surgery"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.sopen.2024.10.009","article-title":"Management of Colorectal Cancer with Synchronous Liver Metastases: A systematic review of national and International Clinical Guidelines (CoSMIC-G)","volume":"22","author":"Chan","year":"2024","journal-title":"Surg. Open Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.annonc.2022.10.003","article-title":"Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Cervantes","year":"2023","journal-title":"Ann. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1093\/annonc\/mdw235","article-title":"ESMO consensus guidelines for the management of patients with metastatic colorectal cancer","volume":"27","author":"Cervantes","year":"2016","journal-title":"Ann. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Members of the AHPBA Professional Standards Committee (2025). Assessment and treatment considerations for patients with colorectal liver metastases: AHPBA consensus guideline and update for surgeons. HPB, 27, 263\u2013278.","DOI":"10.1016\/j.hpb.2024.12.006"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102926","DOI":"10.1016\/j.ctrv.2025.102926","article-title":"EORTC consensus recommendations on the optimal management of colorectal cancer liver metastases","volume":"136","author":"Bregni","year":"2025","journal-title":"Cancer Treat. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ctrv.2015.06.006","article-title":"Managing synchronous liver metastases from colorectal cancer: A multidisciplinary international consensus","volume":"41","author":"Adam","year":"2015","journal-title":"Cancer Treat. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1200\/JCO.22.01690","article-title":"Treatment of Metastatic Colorectal Cancer: ASCO Guideline","volume":"41","author":"Morris","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_20","unstructured":"Kalil, J.A., Adam, R., Meti, N., and Metrakos, P. (Cancers, 2026). A contemporary review of resectability and treatment strategies for colorectal liver metastases: Part 2\u2014Advanced surgical techniques, conversion strategies, and the expanding boundaries of treatment, Cancers, in press."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41073-019-0064-8","article-title":"SANRA\u2014A scale for the quality assessment of narrative review articles","volume":"4","author":"Baethge","year":"2019","journal-title":"Res. Integr. Peer Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s11605-021-05164-1","article-title":"Imaging of Colorectal Liver Metastasis","volume":"26","author":"Baghdadi","year":"2022","journal-title":"J. Gastrointest. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1148\/radiol.10100729","article-title":"Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and\/or FDG PET\/CT: A meta-analysis of prospective studies including patients who have not previously undergone treatment","volume":"257","author":"Niekel","year":"2010","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4329\/wjr.v7.i7.157","article-title":"Non-invasive diagnostic imaging of colorectal liver metastases","volume":"7","author":"Mainenti","year":"2015","journal-title":"World J. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1001\/jama.2014.3740","article-title":"Effect of PET before liver resection on surgical management for colorectal adenocarcinoma metastases: A randomized clinical trial","volume":"311","author":"Moulton","year":"2014","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1001\/jamaoncol.2015.2943","article-title":"Management and Outcome of Colorectal Cancer Liver Metastases in Elderly Patients: A Population-Based Study","volume":"1","author":"Booth","year":"2015","journal-title":"JAMA Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/s12957-020-02055-8","article-title":"Liver resection for colorectal liver-limited metastases in elderly patients: A propensity score matching analysis","volume":"18","author":"Jin","year":"2020","journal-title":"World J. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12957-020-01950-4","article-title":"Multidisciplinary treatment for colorectal liver metastases in elderly patients","volume":"18","author":"Hata","year":"2020","journal-title":"World J. Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.semcancer.2020.09.008","article-title":"Limitations in resectability of colorectal liver metastases 2020\u2014A systematic approach for clinicians and patients","volume":"71","author":"Schadde","year":"2021","journal-title":"Semin. Cancer Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1245\/s10434-012-2864-7","article-title":"Optimal future liver remnant in patients treated with extensive preoperative chemotherapy for colorectal liver metastases","volume":"20","author":"Shindoh","year":"2013","journal-title":"Ann. Surg. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1477-2574.2012.00557.x","article-title":"Selection for hepatic resection of colorectal liver metastases: Expert consensus statement","volume":"15","author":"Adams","year":"2013","journal-title":"HPB"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1016\/j.hpb.2023.06.001","article-title":"Joint EANM\/SNMMI\/IHPBA procedure guideline for [(99m)Tc]Tc-mebrofenin hepatobiliary scintigraphy SPECT\/CT in the quantitative assessment of the future liver remnant function","volume":"25","author":"Arntz","year":"2023","journal-title":"HPB"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101868","DOI":"10.1016\/j.gassur.2024.10.023","article-title":"Optimal treatment strategies for borderline resectable liver metastases from colorectal cancer","volume":"29","author":"Varty","year":"2025","journal-title":"J. Gastrointest. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"644\u2013657; discussion 657\u2013648","DOI":"10.1097\/01.sla.0000141198.92114.f6","article-title":"Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: A model to predict long-term survival","volume":"240","author":"Adam","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/00000658-199909000-00004","article-title":"Clinical Score for Predicting Recurrence After Hepatic Resection for Metastatic Colorectal Cancer","volume":"230","author":"Fong","year":"1999","journal-title":"Ann. Surg."},{"key":"ref_36","first-page":"1254","article-title":"Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients","volume":"77","author":"Nordlinger","year":"1996","journal-title":"Assoc. Fran\u00e7aise De Chir. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"6305","DOI":"10.3748\/wjg.v12.i39.6305","article-title":"Proposal of criteria to select candidates with colorectal liver metastases for hepatic resection: Comparison of our scoring system to the positive number of risk factors","volume":"12","author":"Nagashima","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/j.1478-3231.2008.01845.x","article-title":"Prognostic factors and evaluation of a clinical score for predicting survival after resection of colorectal liver metastases","volume":"29","author":"Konopke","year":"2009","journal-title":"Liver Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1007\/s11605-021-04962-x","article-title":"Prognostic and Therapeutic Implications of Tumor Biology, Including Gene Alterations, in Colorectal Liver Metastases","volume":"25","author":"Nishioka","year":"2021","journal-title":"J. Gastrointest. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00262-017-2094-8","article-title":"The Immunoscore system predicts prognosis after liver metastasectomy in colorectal cancer liver metastases","volume":"67","author":"Wang","year":"2018","journal-title":"Cancer Immunol. Immunother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/SLA.0000000000002450","article-title":"Deleterious Effect of RAS and Evolutionary High-risk TP53 Double Mutation in Colorectal Liver Metastases","volume":"269","author":"Chun","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/XCS.0000000000000223","article-title":"Colorectal Liver Micrometastases: Association with RAS\/TP53 Co-Mutation and Prognosis after Surgery","volume":"235","author":"Chun","year":"2022","journal-title":"J. Am. Coll. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1097\/SLA.0000000000003527","article-title":"Extended Molecular Profiling Improves Stratification and Prediction of Survival After Resection of Colorectal Liver Metastases","volume":"270","author":"Lang","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5843","DOI":"10.1158\/1078-0432.CCR-19-0863","article-title":"Mutation Status of RAS, TP53, and SMAD4 is Superior to Mutation Status of RAS Alone for Predicting Prognosis after Resection of Colorectal Liver Metastases","volume":"25","author":"Kawaguchi","year":"2019","journal-title":"Clin. Cancer Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1245\/s10434-024-16319-0","article-title":"Evaluating Combinations of Biological and Clinicopathologic Factors Linked to Poor Outcomes in Resected Colorectal Liver Metastasis: An External Validation Study","volume":"32","author":"Sasaki","year":"2025","journal-title":"Ann. Surg. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"6815","DOI":"10.1245\/s10434-023-13750-7","article-title":"Integration of Next-Generation Sequencing in the Surgical Management of Colorectal Liver Metastasis","volume":"30","author":"Pham","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/S1470-2045(09)70081-6","article-title":"Liver resection for metastatic colorectal cancer in the presence of extrahepatic disease","volume":"10","author":"Carpizo","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1111\/codi.15113","article-title":"Pulmonary Metastasectomy in Colorectal Cancer: Updated analysis of 93 randomized patients\u2014Control survival is much better than previously assumed","volume":"22","author":"Milosevic","year":"2020","journal-title":"Colorectal Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1111\/j.1477-2574.2009.00115.x","article-title":"Long-term outcome after sequential resections of liver and lung metastases from colorectal carcinoma","volume":"11","author":"Marudanayagam","year":"2009","journal-title":"HPB"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.hpb.2015.12.004","article-title":"Resection of colorectal liver metastases and extra-hepatic disease: A systematic review and proportional meta-analysis of survival outcomes","volume":"18","author":"Hadden","year":"2016","journal-title":"HPB"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/DCR.0b013e3182739f5e","article-title":"Outcome of strict patient selection for surgical treatment of hepatic and pulmonary metastases from colorectal cancer","volume":"56","author":"Robles","year":"2013","journal-title":"Dis. Colon. Rectum"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1002\/bjs.9783","article-title":"Surgical management of patients with colorectal cancer and simultaneous liver and lung metastases","volume":"102","author":"Andres","year":"2015","journal-title":"Br. J. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Berlin, C., Andrieux, G., Menzel, M., St\u00f6ger, G.J., Gengenbach, A., Sch\u00e4fer, L., Hillebrecht, H.C., Kesselring, R., Le, U.-T., and Fichtner-Feigl, S. (2024). Long-Term Outcome After Resection of Hepatic and Pulmonary Metastases in Multivisceral Colorectal Cancer. Cancers, 16.","DOI":"10.3390\/cancers16223741"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1016\/S1470-2045(16)30500-9","article-title":"Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: An analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database","volume":"17","author":"Franko","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/S1470-2045(20)30599-4","article-title":"Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): A multicentre, randomised, open-label, phase 3 trial","volume":"22","author":"Elias","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"109","DOI":"10.21037\/atm.2019.12.125","article-title":"Liver resection is beneficial for patients with colorectal liver metastases and extrahepatic disease","volume":"8","author":"Hasselgren","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3672","DOI":"10.1200\/JCO.2007.15.7297","article-title":"Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement?","volume":"26","author":"Adam","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1007\/BF02557264","article-title":"Significance of hepatic pedicle lymph node involvement in patients with colorectal liver metastases: A prospective study","volume":"9","author":"Jaeck","year":"2002","journal-title":"Ann. Surg. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.ejso.2016.10.033","article-title":"Regional lymph node involvement in patients undergoing liver resection for colorectal cancer metastases","volume":"43","author":"Nanji","year":"2017","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1245\/s10434-011-1902-1","article-title":"Colorectal liver metastasis in the setting of lymph node metastasis: Defining the benefit of surgical resection","volume":"19","author":"Bodingbauer","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1097\/SLA.0b013e3181a334d9","article-title":"Long-term survival after liver resection for colorectal liver metastases in patients with hepatic pedicle lymph nodes involvement in the era of new chemotherapy regimens","volume":"249","author":"Oussoultzoglou","year":"2009","journal-title":"Ann. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1016\/S1470-2045(13)70447-9","article-title":"Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): Long-term results of a randomised, controlled, phase 3 trial","volume":"14","author":"Nordlinger","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/S0140-6736(08)60455-9","article-title":"Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): A randomised controlled trial","volume":"371","author":"Nordlinger","year":"2008","journal-title":"Lancet"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3789","DOI":"10.1200\/JCO.21.01032","article-title":"Hepatectomy Followed by mFOLFOX6 Versus Hepatectomy Alone for Liver-Only Metastatic Colorectal Cancer (JCOG0603): A Phase II or III Randomized Controlled Trial","volume":"39","author":"Kanemitsu","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1007\/s11605-021-05175-y","article-title":"Neoadjuvant Chemotherapy Versus Upfront Surgery for Resectable Liver Metastases from Colorectal Cancer: A Multicenter, Propensity Score-Matched Cohort Study","volume":"26","author":"Hirokawa","year":"2022","journal-title":"J. Gastrointest. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12957-019-1641-5","article-title":"Optimal indication criteria for neoadjuvant chemotherapy in patients with resectable colorectal liver metastases","volume":"17","author":"Ichida","year":"2019","journal-title":"World J. Surg. Oncol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Zhu, D., Zhong, Y., Wei, Y., Ye, L., Lin, Q., Ren, L., Ye, Q., Liu, T., Xu, J., and Qin, X. (2014). Effect of neoadjuvant chemotherapy in patients with resectable colorectal liver metastases. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0086543"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.4251\/wjgo.v14.i7.1281","article-title":"Efficacy of neoadjuvant chemotherapy for initially resectable colorectal liver metastases: A retrospective cohort study","volume":"14","author":"Takeda","year":"2022","journal-title":"World J. Gastrointest. Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Chen, F.L., Wang, Y.Y., Liu, W., and Xing, B.C. (2022). Neoadjuvant chemotherapy improves overall survival in resectable colorectal liver metastases patients with high clinical risk scores\u2014A retrospective, propensity score matching analysis. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.973418"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/S1470-2045(19)30798-3","article-title":"Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis (New EPOC): Long-term results of a multicentre, randomised, controlled, phase 3 trial","volume":"21","author":"Bridgewater","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.annonc.2024.11.012","article-title":"Pembrolizumab versus chemotherapy in microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer: 5-year follow-up from the randomized phase III KEYNOTE-177 study","volume":"36","author":"Shiu","year":"2025","journal-title":"Ann. Oncol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0140-6736(24)02848-4","article-title":"Nivolumab plus ipilimumab versus nivolumab in microsatellite instability-high metastatic colorectal cancer (CheckMate 8HW): A randomised, open-label, phase 3 trial","volume":"405","author":"Elez","year":"2025","journal-title":"Lancet"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S1470-2045(24)00660-0","article-title":"Thermal ablation versus surgical resection of small-size colorectal liver metastases (COLLISION): An international, randomised, controlled, phase 3 non-inferiority trial","volume":"26","author":"Puijk","year":"2025","journal-title":"Lancet Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ejca.2023.03.038","article-title":"A prospective multicentre trial on survival after Microwave Ablation VErsus Resection for Resectable Colorectal liver metastases (MAVERRIC)","volume":"187","author":"Tinguely","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Wada, Y., Takami, Y., Ryu, T., Uchino, Y., Kugiyama, T., Nomura, Y., and Saitsu, H. (2023). Predictive Factors for Local Recurrence after Intraoperative Microwave Ablation for Colorectal Liver Metastases. Cancers, 15.","DOI":"10.3390\/cancers15010122"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Li, Z., Yan, T., and Cai, X. (2024). Comparative efficacy of microwave ablation and radiofrequency ablation for treating metastatic liver cancer: A systematic review and meta-analysis. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1473780"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e990","DOI":"10.1634\/theoncologist.2018-0337","article-title":"Radiofrequency Ablation and Microwave Ablation in Liver Tumors: An Update","volume":"24","author":"Izzo","year":"2019","journal-title":"Oncologist"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"8991","DOI":"10.1007\/s00464-023-10468-1","article-title":"SAGES\/AHPBA guidelines for the use of microwave and radiofrequency liver ablation for the surgical treatment of hepatocellular carcinoma or colorectal liver metastases less than 5 cm","volume":"37","author":"Ceppa","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1245\/s10434-010-1108-y","article-title":"Factors determining the sensitivity of intraoperative ultrasonography in detecting colorectal liver metastases in the modern era","volume":"17","author":"Pawlik","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S1365-182X(17)30755-4","article-title":"The Brisbane 2000 Terminology of Liver Anatomy and Resections","volume":"2","author":"Strasberg","year":"2000","journal-title":"HPB"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/SLA.0b013e31825a01f6","article-title":"Use and dissemination of the brisbane 2000 nomenclature of liver anatomy and resections","volume":"257","author":"Strasberg","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/SLA.0b013e3181557e47","article-title":"Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: Trends in treatment over time in 440 patients","volume":"247","author":"Gold","year":"2008","journal-title":"Ann. Surg."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/jhbp.1091","article-title":"The Tokyo 2020 terminology of liver anatomy and resections: Updates of the Brisbane 2000 system","volume":"29","author":"Wakabayashi","year":"2022","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3718","DOI":"10.1245\/s10434-016-5278-0","article-title":"Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases","volume":"23","author":"Matsumura","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"101631","DOI":"10.1016\/j.suronc.2021.101631","article-title":"Parenchymal-sparing hepatectomy for colorectal liver metastases reduces postoperative morbidity while maintaining equivalent oncologic outcomes compared to non-parenchymal-sparing resection","volume":"38","author":"Andreou","year":"2021","journal-title":"Surg. Oncol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1007\/s11605-017-3397-y","article-title":"Parenchymal-Sparing Versus Anatomic Liver Resection for Colorectal Liver Metastases: A Systematic Review","volume":"21","author":"Moris","year":"2017","journal-title":"J. Gastrointest. Surg."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1159\/000479336","article-title":"Parenchymal-Sparing Surgery for the Surgical Treatment of Multiple Colorectal Liver Metastases Is a Safer Approach than Major Hepatectomy Not Impairing Patients\u2019 Prognosis: A Bi-Institutional Propensity Score-Matched Analysis","volume":"35","author":"Donadon","year":"2018","journal-title":"Dig. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/SLA.0000000000001194","article-title":"Parenchymal-sparing Hepatectomy in Colorectal Liver Metastasis Improves Salvageability and Survival","volume":"263","author":"Mise","year":"2016","journal-title":"Ann. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/SLA.0000000000002367","article-title":"Anatomical Resections Improve Disease-free Survival in Patients With KRAS-mutated Colorectal Liver Metastases","volume":"266","author":"Margonis","year":"2017","journal-title":"Ann. Surg."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s11605-019-04299-6","article-title":"Anatomic Resection Is Not Required for Colorectal Liver Metastases with RAS Mutation","volume":"24","author":"Joechle","year":"2020","journal-title":"J. Gastrointest. Surg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/bjs.1800730917","article-title":"Determinants of survival in liver resection for colorectal secondaries","volume":"73","author":"Ekberg","year":"1986","journal-title":"Br. J. Surg."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/01.sla.0000160703.75808.7d","article-title":"Effect of Surgical Margin Status on Survival and Site of Recurrence After Hepatic Resection for Colorectal Metastases","volume":"241","author":"Pawlik","year":"2005","journal-title":"Ann. Surg."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s11605-021-05173-0","article-title":"Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for Colorectal Liver Metastases","volume":"26","author":"Nishioka","year":"2022","journal-title":"J. Gastrointest. Surg."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.surg.2020.11.024","article-title":"Recurrence at surgical margin following hepatectomy for colorectal liver metastases is not associated with R1 resection and does not impact survival","volume":"169","author":"Andreou","year":"2021","journal-title":"Surgery"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/j.ejso.2019.03.010","article-title":"Sub-millimeter surgical margin is acceptable in patients with good tumor biology after liver resection for colorectal liver metastases","volume":"45","author":"Xu","year":"2019","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1245\/s10434-016-5609-1","article-title":"KRAS Mutation Status Dictates Optimal Surgical Margin Width in Patients Undergoing Resection of Colorectal Liver Metastases","volume":"24","author":"Margonis","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"109732","DOI":"10.1016\/j.ejso.2025.109732","article-title":"Simultaneous versus delayed resection of synchronous colorectal liver metastases: A systematic review and meta-analysis","volume":"51","author":"Lakha","year":"2025","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"8198","DOI":"10.1245\/s10434-021-10220-w","article-title":"Liver-First Approach for Synchronous Colorectal Metastases: Analysis of 7360 Patients from the LiverMetSurvey Registry","volume":"28","author":"Giuliante","year":"2021","journal-title":"Ann. Surg. Oncol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.hpb.2021.01.002","article-title":"Synchronous resection of colorectal cancer primary and liver metastases: An outcomes analysis","volume":"23","author":"Driedger","year":"2021","journal-title":"HPB"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijsu.2019.12.009","article-title":"Simultaneous versus staged resection for synchronous colorectal liver metastases: A population-based cohort study","volume":"74","author":"Bogach","year":"2020","journal-title":"Int. J. Surg."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/SLA.0000000000003848","article-title":"Simultaneous Versus Delayed Resection for Initially Resectable Synchronous Colorectal Cancer Liver Metastases: A Prospective, Open-label, Randomized, Controlled Trial","volume":"273","author":"Boudjema","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"3110","DOI":"10.1007\/s00268-019-05142-4","article-title":"Timing of Perioperative Chemotherapy Does Not Influence Long-Term Outcome of Patients Undergoing Combined Laparoscopic Colorectal and Liver Resection in Selected Upfront Resectable Synchronous Liver Metastases","volume":"43","author":"Ratti","year":"2019","journal-title":"World J. Surg."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1002\/jso.23899","article-title":"Role of neoadjuvant chemotherapy in resectable synchronous colorectal liver metastasis; An international multi-center data analysis using LiverMetSurvey","volume":"111","author":"Bonney","year":"2015","journal-title":"J. Surg. Oncol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/annonc\/mdh095","article-title":"Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer","volume":"15","author":"Audard","year":"2004","journal-title":"Ann. Oncol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1002\/bjs.10572","article-title":"Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases","volume":"104","author":"Zhao","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Papakonstantinou, M., Fantakis, A., Torzilli, G., Donadon, M., Chatzikomnitsa, P., Giakoustidis, D., Papadopoulos, V.N., and Giakoustidis, A. (2025). A Systematic Review of Disappearing Colorectal Liver Metastases: Resection or No Resection?. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041147"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1001\/jamasurg.2020.0802","article-title":"Review of the Southampton Consensus Guidelines for Laparoscopic Liver Surgery","volume":"155","author":"Ejaz","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1200\/JCO.23.01019","article-title":"Laparoscopic Versus Open Hemihepatectomy: The ORANGE II PLUS Multicenter Randomized Controlled Trial","volume":"42","author":"Fichtinger","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1007\/s00464-023-09895-x","article-title":"SAGES\/AHPBA guidelines for the use of minimally invasive surgery for the surgical treatment of colorectal liver metastases (CRLM)","volume":"37","author":"Vreeland","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Tie, J., Wang, Y., Cohen, J., Li, L., Hong, W., Christie, M., Wong, H.L., Kosmider, S., Wong, R., and Thomson, B. (2021). Circulating tumor DNA dynamics and recurrence risk in patients undergoing curative intent resection of colorectal cancer liver metastases: A prospective cohort study. PLoS Med., 18.","DOI":"10.1371\/journal.pmed.1003620"},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Kalil, J.A., Krzywon, L., Petrillo, S.K., Tsamchoe, M., Zlotnik, O., Lazaris, A., and Metrakos, P. (2024). Feasibility of ctDNA in detecting minimal residual disease and predicting recurrence for colorectal cancer liver metastases. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1418696"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1016\/j.annonc.2024.08.2240","article-title":"Survival benefit of adjuvant chemotherapy based on molecular residual disease detection in resected colorectal liver metastases: Subgroup analysis from CIRCULATE-Japan GALAXY","volume":"35","author":"Kataoka","year":"2024","journal-title":"Ann. Oncol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"110179","DOI":"10.1016\/j.surg.2026.110179","article-title":"Total neoadjuvant therapy for rectal cancer: Implications for subsequent liver metastases and chemotherapy-associated liver injury","volume":"194","author":"Ito","year":"2026","journal-title":"Surgery"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3165\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:31:10Z","timestamp":1790843470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/19\/3165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":113,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["cancers18193165"],"URL":"https:\/\/doi.org\/10.3390\/cancers18193165","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}