Current status and advances in the treatment of colorectal cancer with liver metastases

The incidence of colorectal cancer is gradually increasing, and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis, with the liver being the most common site of metastasis. Unlike most malignant tumors, patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected. With advances in systemic therapies, many patients with initially unresectable liver metastases from colorectal cancer can undergo systemic treatment to achieve conversion therapy, thereby gaining the opportunity for surgery. However, there is still no consensus on several issues, including the timing of systemic therapy before and after surgery, whether neoadjuvant therapy should be employed, and the choice between simultaneous or staged surgeries. This review aims to systematically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues, providing valuable insights for the diagnosis and treatment of colorectal liver metastases.