The primary objective is to demonstrate superiority of neoadjuvant systemic therapy followed by repeat local treatment as compared to upfront repeat local treatment in patients with at least one locally treatable recurrent CRLM in the absence of extrahepatic disease.
Age >18 years
Good performance status (ECOG 0-2 // ASA 1-3)
Histological documentation of primary colorectal tumor
Local treatment performed for initial CRLM
Extrahepatic disease
MSI/dMMR
Radical local treatment unfeasible or unsafe (e.g. insufficient future liver volume)
Compromised liver function (e.g. signs of portal hypertension, INR > 1,5 without use of anticoagulants, ascites)