Liver surgery combo fails to show clear survival edge in advanced colorectal cancer

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Patients with synchronous or metachronous diagnosis of resectable liver metastases by computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen * Patients requiring percutaneous or intraoperative ablation of liver metastases \< 2 cm in size are eligible * Patients who underwent prior liver resection or ablation for colorectal liver metastases are eligible * Patients previously treated with systemic chemotherapy and/or biologic agents for colorectal cancer are eligible * The primary tumor in the colon or rectum may be intact or resected * Low-volume lung metastases are defined as solid pulmonary nodules \< 2 cm with non-spiculated contours, no benign-appearing calcifications, and =\< 14 in number, diagnosed by computed tomography of the chest or positron emission tomography (PET) * Lung metastases will be unresectable due to anatomic location, distribution, or patients' comorbidities, as determined by review of imaging by a faculty member in the Department of Thoracic \& Cardiovascular Surgery * Patients must sign a study-specific consent form * Patients will undergo CT imaging of the chest, abdomen, and pelvis to evaluate lung and liver metastases within 60 days of registration; for patients who cannot tolerate CT contrast or have hepatic steatosis that reduces the sensitivity of CT, MRI of the liver will be performed Exclusion Criteria: * Radiographic evidence of disease other than liver and lungs, with the exception of mediastinal lymph nodes \< 2 cm and hepatoduodenal ligament lymphadenopathy, diagnosed by computed tomography, magnetic resonance imaging, or positron emission tomography * Serum bilirubin \>= 2 mg/dL * Platelet count \< 50,000/uL * Eastern Cooperative Oncology Group (ECOG) performance status of 3-4 * Patient refusal to participate in randomization * Pregnant women are excluded from this study * Planned stereotactic body radiation therapy (SBRT) for the pulmonary metastases