Synchronous colorectal liver metastasis – simultaneous vs. staged approach

Synchronous colorectal liver metastases are found in up to a quarter of patients at the time of initial colorectal cancer diagnosis. The decision of how best to approach this situation remains an area of active debate with both a simultaneous approach (combined liver and colorectal surgery) and staged approaches (either colon or liver operation first followed by the other) being acceptable options at this time. In this chapter, we will review the different approaches and the available literature supporting each of the three options as well as discuss the timing of each surgical option within the greater framework of multimodal management of synchronous colorectal liver metastases.