Managing the Primary Tumor with Unresectable Synchronous Colorectal Metastases

Colorectal cancer is the third most commonly diagnosed cancer in men and the second most common in women. Approximately 20 % of patients with colorectal cancer are found to have metastatic disease (stage IV) at the time of diagnosis. A multidisciplinary approach provides the best chance for a potentially curative option in selected patients with metastases, but in most patients, the metastases are unresectable. The treatment strategy for this entity is not fully established, especially regarding whether and when the primary tumor should be resected. In this manuscript, we review current evidence regarding approaches to the primary tumor in patients with unresectable synchronous metastases from colorectal cancer.