Synchronous colorectal liver metastases: timing of resection and patterns of referral

There remain no consensus guidelines on the optimum surgical strategy for the management of synchronous colorectal liver metastases in spite of a number of published reviews and meta-analyses (1,2). In their paper, Howard et al. describe the ‘real world’ referral patterns and resection pathways of Canadian surgeons for this challenging patient cohort (3). This is a timely and interesting area for study. Data was generated from an online survey sent out to all surgeons in Canada. Responses were received from 58 surgeons but 6 responses were inadequate for analysis leaving 52 surgeon responses included for analysis.