**3.6 Role of adjuvant therapy for resected colorectal cancer metastases**

Liver is the commonest site of metastases in colon cancer. Unlike many other solid organ cancers, metastasectomy improves survival in colorectal cancer, where 5-year overall survival may reach 50%. The best postoperative management strategy is not well defined, however, often perioperative chemotherapy is utilized in the form of FOLFOX or CAPOX with agents like irinotecan, anti-EGFR, or anti-VEFG therapy often added for eligible patients in the neoadjuvant setting if downstaging was necessary. In the EORTC 40983 trial, perioperative chemotherapy was associated with 7.3% absolute increase in 3-year progression-free survival, however there was no difference in overall survival [29, 30]. Another Japanese study also did not show overall survival benefit with adjuvant chemotherapy [31]. Given the established role of adjuvant therapy in stage III colon cancer, despite lack of strong evidence many expert groups support perioperative or postoperative chemotherapy for resectable colorectal cancer metastases.
