The argument for liver resection in colorectal liver metastases

The first liver resection for colorectal metastasis was performed by Cattell in 1940. Unfortunately, there has never been a randomized control trial for liver resection against other treatment modalities (best supportive care, palliative chemotherapy, etc). Since this operation is now well established in the surgical repertoire, it would now be ethically difficult to undertake such a trial.