Liver metastases can be resected with curative intention. If a resection of the metastases is not initially possible, it may be performed in some patients following neoadjuvant chemotherapy, resulting in a 5-year survival rate of 33%. Because tumor shrinkage is required for resection, and due to the correlation between resection rate and tumor response rate, a first line therapy with high response rates should be offered to patients. With this aim, the therapy is different from palliative therapy for metastatic colorectal cancer. It requires good interdisciplinary cooperation. High response rates may be achieved with a combination of antibodies and irinotecan or oxaliplatin containing infusional 5-FU combinations. Experimental approaches with more intensive regimens are under investigation. With standard chemotherapies such as FOLFOX or FOLFIRI, studies have shown that 10% of patients with metastatic colorectal cancer are secondarily resected; in studies with a neoadjuvant focus, a resection rate of 30% was observed.