skip to main content

Colorectal Cancer — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardGI CancersColorectal CancerSCE Medical Oncology

Four initially borderline colorectal liver metastases become completely resectable after three months of conversion chemotherapy. No extrahepatic disease is evident and the liver MDT agrees an R0 resection is feasible. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Proceed to liver resection through the specialist MDT rather than treating to radiological disappearance

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

B is correct. NICE recommends considering resection for liver-limited colorectal metastases after discussion by an MDT with expertise in all involved sites, with perioperative systemic therapy considered. Once conversion has made an R0 resection feasible, unnecessary further intensive treatment risks neuropathy, liver injury and disappearance of lesions without proving eradication. Maintenance therapy abandons the curative opportunity, and ablation is generally considered when lesions are unsuitable for resection or as an MDT-selected adjunct. The original rigid claim of an optimal three-to-four-month total course was replaced by the clinically decisive point: operate once resectability is achieved.

Reference: NICE NG151 colorectal cancer recommendations: https://www.nice.org.uk/guidance/ng151/chapter/Recommendations