Approximately 20% of patients with CRC have metastatic disease at the time of diagnosis, and another 25% will develop metastases following diagnosis. Although the liver is the most common site of distant metastasis, metastases may also occur in the ovaries, adrenal glands, lung, bone, brain, and kidneys. Patients are generally not considered candidates for liver metastasis resection if they have an additional metastasis at another site. However, about 10% to 20% of patients with an isolated liver metastasis and a resectable primary tumor are candidates for potentially curative surgery to remove the liver metastasis. Between 20% and 35% of these patients can expect to live an additional 5 years, and surgical mortality is relatively low, at less than 5%.

The use of neoadjuvant chemotherapy can sometimes downstage liver metastases to the point where an unresectable lesion becomes operable and amenable to a potential cure.