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Synchronous Liver Metastases — SCE Medical Oncology MCQ

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EasyGI CancersSynchronous Liver MetastasesSCE Medical Oncology

A 62-year-old man with colon cancer has a 2 cm liver metastasis discovered on staging CT. The primary tumour is resectable. He has no other metastatic disease. What is the optimal surgical strategy?

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Correct answer: E — Simultaneous resection of the primary tumour and liver metastasis (synchronous approach) if technically feasible

Synchronous colorectal liver metastases amenable to complete resection should be treated with curative intent. Simultaneous resection (colonic primary + liver metastasectomy) is increasingly performed in selected patients with limited hepatic disease burden, avoiding two separate operations. Alternative strategies include: liver-first approach (for critically located liver metastases) or primary-first with interval liver resection. Five-year survival after R0 hepatic metastasectomy is approximately 40-50%.

Reference: NICE NG151; ESMO 2024 mCRC Guidelines