# Simultaneous resection of colorectal cancer and liver metastases

**Authors:** Raphael Leonardo Cunha ARAUJO, Marcelo Moura LINHARES, Antonio Roberto Franchi TEIXEIRA, Aleksandar KARAMARKOVIC, Hugo Pinto MARQUES, Timothy M. PAWLIK, Rene ADAM, Olivier SOUBRANE, Maria Ignez BRAGHIROLI, Paulo HERMAN, Ricardo Lemos COTTA-PEREIRA

PMC · DOI: 10.1590/0102-67202025000014e1883 · 2025-07-21

## TL;DR

The paper discusses treating colorectal cancer and liver metastases at the same time, which may be safe and effective for carefully selected patients.

## Contribution

It highlights the safety and potential benefits of simultaneous resection while noting the lack of consensus on optimal treatment timing.

## Key findings

- Simultaneous treatment of colorectal cancer and liver metastases is safe for selected patients.
- There is no consensus on the best timing for treating the primary tumor and metastases.
- Performance status and symptoms influence treatment sequence decisions.

## Abstract

Synchronous colorectal liver metastases represents an important prognostic factor for recurrence-free survival and overall survivalSimultaneous approaches to treat colorectal cancer and colorectal liver metastases seem to be safe for patients carefully selectedThere is no consensus about the optimal timing to approach the primary tumor and colorectal liver metastases

Synchronous colorectal liver metastases represents an important prognostic factor for recurrence-free survival and overall survival

Simultaneous approaches to treat colorectal cancer and colorectal liver metastases seem to be safe for patients carefully selected

There is no consensus about the optimal timing to approach the primary tumor and colorectal liver metastases

The presence of synchronous colorectal liver metastases represents an important prognostic factor for recurrence-free survival and overall survival, the definitions of synchronicity are variable in the literature, including metastases at the time of diagnosis, or even before the diagnostic of the primary site of colorectal cancer, and until either six or 12 months after the time of diagnosis, according to the authors of the studies.

Simultaneous approaches to treat colorectal cancer and colorectal liver metastases seem to be safe for patients carefully selected without jeopardizing oncologic outcomes, with similar complication rates, shorter length of stay and operation times even for major hepatectomies. However, there is no consensus about the optimal timing to approach the primary tumor and colorectal liver metastases, whether simultaneously or staged, and both performance status and presence of symptoms play important roles in the treatment sequence, perhaps avoiding two high-risk procedures at the same time

Although the presence of synchronous colorectal liver metastases (CRLM) represents an important prognostic factor for recurrence-free survival (RFS) and overall survival (OS), the definitions of synchronicity are variable in the literature, including metastases at the time of diagnosis, or even before the diagnostic of the primary site of colorectal cancer (CRC), until either six or 12 months after the time of diagnosis, according to the author of each study. Simultaneous approaches to treat CRC and CRLM seem to be safe for patients carefully selected without jeopardizing oncologic outcomes, with similar complication rates, shorter hospital length of stay, and operation times even for major hepatectomies. However, there is no consensus about the optimal timing to approach the primary tumor and CRLM, whether simultaneously or staged, and both performance status and the presence of symptoms play important roles in the treatment sequence, perhaps avoiding two high-risk procedures at the same time.

## Linked entities

- **Diseases:** colorectal cancer (MONDO:0005575), breast cancer (MONDO:0004989)

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12286613/full.md

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Source: https://tomesphere.com/paper/PMC12286613