After a colectomy for colon cancer, what is the most appropriate treatment for a patient found to have liver metastases?

The most appropriate treatment for a patient with liver metastases following a colectomy for colon cancer is chemotherapy followed by surgical resection. This approach is supported by evidence indicating that systemic chemotherapy can reduce the size of liver metastases, making them more amenable for surgical removal. The combination of chemotherapy with surgery often leads to improved survival rates compared to surgery alone.

In managing colorectal cancer with liver metastases, it's crucial to consider the possibility of resecting metastases if they are limited and isolated. Chemotherapy plays a pivotal role in the neoadjuvant setting, shrinking tumors and potentially allowing for a curative approach through resection when the patient responds well to treatment.

Other treatment options, such as observation, do not actively treat the metastatic disease and may lead to disease progression, while using radiotherapy is typically not indicated for hepatic metastases from colon cancer as a primary treatment modality. Surgery alone without prior chemotherapy may also overlook the significant benefits of systemic treatment for effective management of the metastatic disease. Thus, the combination of chemotherapy followed by surgical intervention is considered the optimal strategy in these scenarios.