Curative approach for stage IV colorectal cancer with multiorgan involvement: What makes sense and what doesn't?

In 2009, there were almost 150,000 cases of colorectal cancer in the United States. Surgical resection of isolated metastatic pulmonary and hepatic disease has demonstrated a 10-year overall survival rate approaching 30%. The data on definitive management in multiorgan disease are not clear and are limited because of small patient cohorts, the nonrandomized nature of studies, and suboptimal chemotherapeutic agents. Current trials demonstrate that long-term survival is feasible in carefully selected patients with multiorgan metastases, including hepatic and extrahepatic involvement. Following is a review of current literature supporting the potentially curative approach to synchronous and metachronous multiorgan metastatic colorectal cancer.