In a patient with colorectal cancer and isolated liver metastasis, which approach may be considered?

• A. Palliative chemotherapy only
• B. Radiation therapy
• C. Immediate liver metastasectomy
• D. Multidisciplinary evaluation; potential liver metastasectomy in selected cases

Answer: (D)

When colorectal cancer has metastases confined to the liver, there is a real potential for cure if the metastases can be surgically removed with adequate remaining liver function. The crucial step is a multidisciplinary evaluation to determine if the liver metastases are technically resectable, whether there is any occult disease outside the liver, and whether the future liver remnant would be sufficient after resection. If resection is feasible, liver metastasectomy can offer the best chance for long-term survival, and planning may include systemic therapy before or after surgery, and advanced strategies (such as staged resections or techniques to grow more liver—like portal vein embolization) for more extensive disease. If resection isn’t feasible, other systemic or local therapies are considered, but the key idea is that a collaborative assessment with potential surgical removal in carefully selected cases is the appropriate approach.