Primary lymph node ratio and hepatic resection for colorectal metastases

Colorectal cancer (CRC) is a leading cause of death worldwide (1). The liver is the most common site for distant metastases, and approximately 50% of patients diagnosed with CRC develop hepatic metastases during the course of their disease (2). Improvements in surgical techniques, anesthesia and multimodal treatment regimens (e.g., neoadjuvant chemotherapy and portal vein embolization) have expanded the indications for liver resection (3). Hepatic resection is nowadays offered to patients previously deemed unresectable, such as those with multiple or bilobar metastases, extrahepatic disease and recurrent tumors.