Complete resection of simultaneous hepatic and pulmonary metastases from metastatic colorectal cancer shows significant survival benefits and should be a key treatment goal for selected patients.

• The 5-year overall survival rate post-metastasectomy is 53.6%, with a 3-year rate of 70.9%.
• Patients undergoing complete metastasectomy had a hazard ratio of 0.30 for overall survival compared to those with isolated liver resection plus systemic treatment.

However, complete resection is achieved in only 45.7% of patients with initial curative intent, with disease progression driving treatment failures.