Multidisciplinary Management of Rectal Cancer with Synchronous Resectable Liver Metastases

Abstract

Liver metastases are the most common manifestation of metastatic disease in colorectal cancer, and synchronous metastases occur in around 50% of patients. In rectal cancer, this presentation is uniquely challenging because of issues related to competing treatments and sequencing of therapy. Though there is published data on the management of rectal tumor and liver metastasis from colorectal cancer (CRC) individually, data on the management of synchronous disease is sparse. This is a heterogeneous group of patients and should be managed on a case by case basis and with multidisciplinary evaluation. To this end, we present four cases that highlight several of the issues associated with the management presenting with resectable synchronous liver metastasis from rectal cancer.