Table 1. Potential risks and benefits of synchronous versus staged resection.

Synchronous			Staged
Benefit	Risk		Benefit	Risk
Reduced complications due to single operation	Increased infectious liver complications due to bacterial contamination from intestinal resection			Increased morbidity associated with multiple procedures
Reduced length of hospital stay	Risk of complications from unresected primary		Reduced complications from unresected primary	Risk of hepatotoxicity from chemotherapy given between colorectal and hepatic resections
	Increased anastomotic complications due to impaired liver function
	Extent of hepatic resection limited due to concomitant intestinal resection		Larger hepatic resections may be performed without increased morbidity
No delay in initiating systemic treatment	Chemotherapy-associated hepatotoxicity may limit extent of liver resection			Risk of complications following colorectal resection may delay chemotherapy prior to liver resection
Opportunity to observe tumor response to neoadjuvant chemotherapy	No opportunity to assess tumor response if resection precedes systemic therapy