Hepatic resection is the gold standard treatment for patients affected by liver-limited colorectal metastases. Reports addressing the impact of multidisciplinary team (MDT) evaluation on survival are controversial. The aim of this study was to evaluate the benefit of MDT management in these patients in our Institution experience. The objective of the analysis was to compare survivals of patients managed within our MDT (MDT cohort) to those of patients referred to surgery from other hospitals without MDT discussion (non-MDT cohort). Of the 523 patients, 229 were included in the MDT cohort and 294 in the non-MDT cohort. No difference between the two groups was found in terms of median overall survival (52.5 vs 53.6 months; HR 1.13; 95% CI, 0.88-1.45; p = 0.344). In the MDT cohort there was a higher number of metastases (4.5 vs 2.7; p < 0.0001). The median duration of chemotherapy was lower in MDT patients (8 vs 10 cycles; p < 0.001). Post-operative morbidity was lower in the MDT cohort (6.2 vs 21.5%; p < 0.001). One hundred and ninety-seven patients in each group were matched by propensity score and no significant difference was observed between the two groups in terms of OS and DFS. Our study does not demonstrate a survival benefit from MDT management, but it allows surgery to patients with a more advanced disease. MDT assessment reduces the median duration of chemotherapy and post-operative morbidities. Colorectal cancer (CRC) is the third most commonly diagnosed cancer in developed countries 1 , ranking second in frequency in Europe 2 , and, despite recent improvements in diagnosis and treatment, is still the third leading cause of cancer-related death. About 25% of CRC patients present at diagnosis with liver metastases and up to half will develop liver metastases over the course of their disease. The introduction of modern combination chemotherapy regimens and targeted therapies 3 and the recent advances in surgical techniques 4 have dramatically improved the survival of patients with liver-limited colorectal metastases over the last decade 5. Nowadays, hepatic resection is the gold standard treatment for patients with liver-limited colorectal metastases with 5-and 10-years survival rates reaching up to 60% and 20%, respectively 6,7. The use of liver remodelling strategies (including portal vein ligation or embolization) and effective conversion treatments with chemotherapeutic (irinotecan and oxaliplatin) and targeted (bevacizumab, cetuximab and panitumumab) agents has contributed to increase to about 25% the rate of patients suitable for surgery 8 .

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