Liver resection for liver metastases goes with 30-40% five years survival. It is estimated that 10% of patients with liver metastases can be subjected to liver resection. In the Västra Götaland region, this number is not achieved. In the present material of 147 patients, the postoperative mortality was 2.7%. Five years survival was 33%. Preoperative chemotherapy and preoperative porta embolisation have extended the indication for liver resection. Reresection after recurrence limited to the liver should be considered in selected cases. Ablative measures are under development and should be evaluated in clinical trials. New chemotherapeutic drugs (oxaliplatin, irinotecan) with improved recurrence rate but with limited gain in survival might have an impact as adjuvant therapy. A surgeon with liver surgery competence should see patients with a presumably resectable cancer.