Criteria for resectability of metastases

Liver

• Complete resection must be feasible based on anatomic grounds and the extent of disease, maintenance of noble hepatic function is required
• There should be no unresectable extrahepatic sites of disease.

Hepatic resection is the treatment of choice for resectable liver metastases from colorectal cancer.

Lung

• Complete resection based on the anatomic location and extent of disease with maintenance of adequate function is required.
• Resectable extra-pulmonary metastases do not preclude resection.
• The primary tumour must be controlled.
• Re-resection can be considered in selected patients.

After resection, adjuvant chemotherapy can be considered.

The patient assessment and decision about treatment options should be done during the multidisciplinary team meeting, in presence of the patient’s general practitioner. The role of the pain clinic in pain management has to be discussed.

The need for a psychosocial help must be evaluated and, if required, the help has to be started.

The follow up procedure is the same than that for patients without metastasis.