Metastatic Colon Cancer: Simultaneous Surgery or Preoperative Systemic Therapy? #danilovma #mknc

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A common and important multidisciplinary dilemma in colorectal oncology:

When a patient has colon cancer with synchronous liver metastases that are technically resectable, what is the optimal strategy?

???? Simultaneous surgery (resection of the primary tumor and liver metastases in one stage)
or
???? Preoperative systemic therapy (neoadjuvant/perioperative chemotherapy) followed by surgery

This is not a simple “surgery vs chemotherapy” debate. It is a question of treatment sequencing and oncologic strategy:
• how to maximize the chance of R0 resection
• how to control micrometastatic disease
• how to reduce the risk of early recurrence
• and how to maintain acceptable surgical safety

In this video, we discuss:

✅ the rationale for simultaneous resection
✅ the role of preoperative / perioperative systemic therapy
✅ key evidence from major studies (including METASYNC and EORTC 40983)
✅ what international guidelines (ESMO, ASCO, NCCN) recommend
✅ how multidisciplinary teams choose the best approach for each patient

The main message:
There is no single universal answer.
Both strategies are valid — the choice depends on:
• tumor burden in the liver
• complexity of liver and colon resection
• biological behavior of the disease
• risk of postoperative complications
• and, most importantly, multidisciplinary team decision-making
Categoria
Oncology
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