Oligometastatic Colorectal Cancer: A Review of Definitions and Patient Selection for Local Therapies
Open accessAbstract
Purpose Nearly one-third of patients diagnosed with colorectal cancer (CRC) will ultimately develop metastatic disease. While a small percentage of patients can be considered for curative resection, more patients have limited disease that can be considered for local therapy. Challenges remain in defining oligometastatic CRC as well as developing treatment strategies guided by high level evidence. Methods In this review, we present the challenges in defining oligometastatic CRC and summarize the current literature on treatment and outcomes of local therapy in patients with metastatic CRC. Results For patients with liver- and/or lung-confined CRC metastases, surgical resection is the standard of care given the potential for long-term progression-free and overall survival. For patients with liver- or lung-confined disease not amenable to surgical resection, non-surgical local therapies, such as thermal ablation, hepatic arterial infusion pump (HAIP), or stereotactic body radiation therapy (SBRT), should be considered. For patients with more advanced disease, such as lymph node or bony metastases, the role of metastasis-directed therapy is controversial. Emerging data suggests that SBRT to ablate all metastases can improve progression-free and overall survival. Conclusion Multidisciplinary management is critical for patients with metastatic CRC due to the complexity of their cases and the nuanced patient, tumor, biological, and anatomical factors that must be weighed when considering local therapy. High-quality prospective randomized data in CRC are needed to further clarify the role of local ablative therapy in patients with unresectable oligometastatic CRC with ongoing studies including the RESOLUTE trial (ACTRN12621001198819) and the upcoming NCTN ERASur trial (NCT05673148).
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While most CRC patients initially respond to therapy, the overall response rate to first-line treatments can vary widely, depending on patient tumor characteristics and treatment regimen.
“While most CRC patients initially respond to therapy, the overall response rate to first-line treatments can vary widely, depending on the patient tumor characteristics and treatment regimen [39].”
From Mechanisms and Strategies to Overcome Drug Resistance in Colorectal Cancer (2025) · cites this paper as [39]
The Resectable Liver-Confined Disease section reports that conversion to resectability after systemic therapy ranges from 10% to 60% and discusses treatment choices that may affect response. That is a narrower outcome in patients with initially unresectable liver metastases, not the overall response rate to first-line treatment across CRC patients. The paper does not establish that most CRC patients initially respond or attribute a range of first-line response rates to tumor characteristics and regimen. (LLM, conf=0.77)
Experimental — accuracy not yet measuredDrug resistance remains a significant challenge in CRC treatment, often leading to treatment failure, poor progression-free survival, and cancer recurrence.
“Despite advancements in these therapeutic modalities, resistance remains a significant challenge, often leading to treatment failure, poor progression-free survival, and cancer recurrence.”
From Mechanisms and Strategies to Overcome Drug Resistance in Colorectal Cancer (2025) · cites this paper as [39]
The Future Directions section discusses recurrence risk after hepatectomy, and the Extrahepatic or Extrapulmonary Disease section reports recurrence and progression-free survival in metastatic CRC. Neither passage attributes those outcomes or treatment failure to drug resistance. A search for drug or chemotherapy resistance found no passage addressing that link. (LLM, conf=0.76)
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Mechanisms and Strategies to Overcome Drug Resistance in Colorectal Cancer
Haynes, J., & Manogaran, P. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26051988 · Cited by 82 · see citing works
“While most CRC patients initially respond to therapy, the overall response rate to first-line treatments can vary widely, depending on the patient tumor characteristics and treatment regimen [39].”
- Authors
- Miller, E. D., Hitchcock, K. E., & Romesser, P. B.
- Affiliations
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- University of Florida Health (US)
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Miller, Eric D.
- Venue
- Journal of Gastrointestinal Cancer
- Published
- 2023-01-18
- Volume
- 54
- Issue
- 4
- Pages
- 1116-1127
- ISSN
- 1941-6628 (ISSN-L)
- 1941-6636
- PMC
- PMC10352468
- OpenAlex
- W4317104609
- Cited by
- 31
- References
- 66
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 10 · 2023: 3
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Gastrointestinal Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (P30 CA16058, P30 CA008748)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
- Keywords
- oligometastatic colorectal cancer, metastatic colorectal cancer, local ablative therapy, metastasis-directed therapy, liver metastasis, lung metastasis, surgical resection, thermal ablation, hepatic arterial infusion pump, stereotactic body radiotherapy, lymph node metastasis, bone metastasis, patient selection, progression-free survival, overall survival
- MeSH terms
- Colonic Neoplasms, Humans, Lung Neoplasms, Prospective Studies, Rectal Neoplasms, Colorectal Neoplasms, Radiosurgery, Patient Selection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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