Treatment Strategies for Primarily Generalized Colorectal Cancer

For patients with primarily generalized colorectal cancer two treatment strategies are compared to establish which strategy gives best overall survival.
The traditional strategy is to first resect the primary colorectal tumour and then treat the metastases with chemotherapy followed if possible by surgery.
The alternative strategy is to first treat the metastases with chemotherapy followed if possible by surgery and only resect the primary colorectal tumour if there is hope for cure or if symptoms develop that necessitates treatment.