LAUSR

Lack of a liver surgeon may lead to failure-to-cure in patients with possibly resectable colorectal liver metastases (CRLM). In our study (https://doi.org/10.1245/s10434-02 1-10030-0), all patients who underwent chemotherapy with palliative intent for CRLM at a community oncology network between 2010 and 2018 were identified from a prospectively maintained cancer registry. Two liver surgeons, blinded towards patient management and outcome, reviewed pretreatment imaging and assigned each scan a newly developed resectability score. The Nominal Group Technique and independent scores were combined to determine the probability of curative intent resection. The study included 72 patients assigned to palliative chemotherapy at Multidisciplinary Tumor Boards without a liver surgeon present. Retrospective review by the two liver surgeons showed overall agreement that resection was possible in 32 (44%) patients. The congruence rate was even higher for patients without extrahepatic disease, 17 (54%). Patients considered resectable by a liver surgeon following re-review had higher rates of right-sided liver metastases only, lower rates of bilobar liver metastases, and lower median number of liver segments involved, compared with patients who were unanimously considered unresectable.