TABLE 1.

Variant 1: Initial treatment for a 52-year-old male without a significant past medical history and an asymptomatic nonobstructing uT3N0 primary rectal tumor 8 cm from the anal verge and a solitary resectable 4 cm metastasis in the right lobe of the liver. KPS 90

Treatment	Rating*	Comments
Initial resection of rectal primary and liver lesion (either concurrent or sequential)	8
Initial systemic 5-FU-based chemotherapy (FOLFOX/FOLFIRI ± bevacizumab)	5
Initial preoperative pelvic RT + concurrent 5-FU-based chemotherapy	3
Resection of the liver lesion only	2
Best supportive care	1

^*Rating scale: 1–3, usually not appropriate; 4–6, may be appropriate; 7–9, usually appropriate.