Twenty-two patients with liver metastases and synchronous extra-hepatic localizations or colorectal cancer underwent complete resection of all their cancerous lesion. Their survival was not significantly different from that of 87 patients in whom single or multiple metastases involving only the liver had been resected. Analysis of our 22 patients showed that they fell into two subgroups: those with lung metastases (n = 5) and those with pediculate colonic nodes (n = 6), who benefited from the double resection since their disease-free survival rate at 5 years was 35 percent. In contrast, patients who had a few peritoneal nodules (n = 8) relapsed during the first 13 postoperative months. The presence of one or a few extra-hepatic lesions does not necessarily preclude resection of the liver metastases, provided they can be resected during the same operation in case of intra-abdominal lesions and during a later operation in case of lung metastases. A single peritoneal nodule may be the first manifestation of peritoneal dissemination and contra-indicates the resection of liver metastases.