longterm survival of patients downstaged by oxaliplatin and 5fluorouracil combination followed by rescue surgery for unresectable colorectal liver metastases objectives to evaluate longterm survival of patients resected for primarily unresectable colorectal liver metastases downstaged by systemic chemotherapymethods among a group of 82 patients with advanced colorectal cancer 39 had unresectable liver metastases after treatment with systemic 3weekly 5fufolinic acidoxaliplatin chemotherapy the outcome of 11 patients made resectable thanks to chemotherapy was compared to that of 28 patients who were not criteria for nonresectability consisted of diffuse bilobar invasion with inability to achieve complete resection unilobar or bilobar invasion plus vascular extension invasion of inferior vena cava or 2 suprahepatic veins plus continuity with the 3rd or involvment of hepatic pedicle before and after surgery ct scan evaluation was performed every 2 months progression free survival was defined as the time between starting chemotherapy and recurrence of the disease we used kaplanmeier survival curves and logrank test for comparisons p values were twosided and considered significant if005results progression free survival times were 14 and 6 months median overall survival were 60 and 185 months respectively in favour of secondary resected subjectsconclusion considering the magnitude of the survival benefit one may question the need and feasibility for trials to assess more formally the impact of surgery in that setting