Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.7014
Peer-review started: December 29, 2014
First decision: January 22, 2015
Revised: February 6, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: June 14, 2015
Processing time: 172 Days and 0.7 Hours
Core tip: There are four treatment strategies available for synchronous liver metastases of colorectal carcinoma (CLM): (1) primary first approach comprises resection of the primary colorectal tumor followed by chemotherapy and liver resection; (2) simultaneous resection of liver and colorectal primary tumor; (3) liver-first (or chemotherapy-first) approach comprises preoperative chemotherapy, liver resection, adjuvant chemotherapy, and resection of the primary colorectal tumor (best for asymptomatic primary tumors and initially unresectable or marginally resectable CLM); and (4) up-front hepatectomy (or “true” liver-first approach) includes liver resection followed by adjuvant chemotherapy and colorectal resection (for asymptomatic primary tumors and initially resectable CLM).