Refining Surgical Strategies in Metastatic Colorectal Cancer

Colorectal cancer with metastatic disease remains a major surgical and oncologic challenge, despite advances in systemic therapy, cross-sectional imaging, interventional radiology, and perioperative care. Surgery may provide durable disease control or long-term survival for selected patients with colorectal liver, peritoneal, pulmonary, or multisite metastases, but the criteria defining resectability and the optimal timing of intervention continue to evolve. Current clinical questions include how biological response to systemic treatment should influence operative decisions, which patients benefit from aggressive local therapy, and whether minimally invasive, robotic, staged, or combined procedures can achieve equivalent oncologic outcomes with reduced morbidity. Contemporary studies increasingly support multidisciplinary, patient-specific treatment planning, yet evidence remains heterogeneous and is frequently derived from retrospective cohorts and selected high-volume centres. Important gaps persist regarding treatment sequencing, repeat resection, conversion therapy, management of synchronous disease, and the integration of surgery with increasingly effective systemic and locoregional treatments. Further investigation is needed to establish reproducible selection criteria and evidence-informed surgical pathways.This Research Topic aims to evaluate and refine contemporary surgical strategies for metastatic colorectal cancer. It will examine how patient characteristics, tumour biology, metastatic distribution, response to systemic therapy, technical feasibility, and institutional expertise should inform decisions about surgery. Contributions may address the assessment of resectability, the selection and timing of metastasectomy, and the comparative effectiveness of open, laparoscopic, robotic, staged, or combined procedures. The Research Topic also seeks to clarify perioperative risks, recurrence patterns, the role of repeat or salvage surgery, and short- and long-term oncologic, functional, and quality-of-life outcomes. By integrating clinical, technical, and outcome-based evidence, it will explore which operative approaches are most effective, for which patients, and under what clinical circumstances.To gather further insights in the surgical management of metastatic colorectal cancer, this Research Topic will focus on operative decision-making and perioperative outcomes across selected metastatic sites and treatment pathways, while recognising the limitations of non-randomised evidence and variation in multidisciplinary practice. We welcome articles addressing, but not limited to, the following themes:- Patient selection for surgery in metastatic colorectal cancer- Resectability criteria and surgical strategies for colorectal liver metastases- Surgical management of peritoneal metastases- Minimally invasive and robotic approaches- Open versus laparoscopic or robotic surgery- Combined and staged resections for synchronous metastatic disease- Multidisciplinary treatment planning and the timing of surgery- Neoadjuvant and conversion therapy followed by surgery- Repeat resection and salvage surgery for recurrent metastatic disease- Perioperative optimisation and reduction of morbidity, mortality, and complications- Oncologic outcomes after metastasectomy- Recurrence patterns and predictors of durable disease control- Quality of life and functional outcomes after surgery- Comparative surgical series, retrospective cohorts, technical evaluations, and original clinical research Topic editors: Erdinc Kamer, Ali Cihat Yildirim, Cihan Ağalar Source: https://www.frontiersin.org/research-topics/85572/refining-surgical-strategies-in-metastatic-colorectal-cancer