Managing potentially resectable metastatic colon cancer

For patients with metastatic colon cancer, management has evolved from resecting a single liver metastasis and having only one chemotherapy medicine, to resecting multiple metastases including those outside the liver as well as using combination chemotherapy (based on recent supportive trials) to improve outcomes. This success has also raised many questions, including the role of adjuvant chemotherapy to downstage borderline resectable tumors, whether patients who receive preoperative chemotherapy should also receive it after surgery, the optimal timing of adjuvant chemotherapy, and which agents should be used. This paper briefly discusses important issues regarding the new management paradigm for patients with resectable metastases from colorectal cancer.