Abstract: ObjectiveTo observe the relationship between tumor regression grade （TRG） and imaging findings after neoadjuvant chemotherapy for resectable patients who were initially considered as unresectable colorectal cancer with liver metastases. 
MethodsFrom January 2012 to June 2017， the clinical data of 26 patients with advanced liver cancer who were initially resectablewere retrospectively analyzed and 6 of them were converted to resectable patients after neoadjuvant chemotherapy. The efficacy and safety were evaluated by RECIST 11 and NCICTC 40 criteria， respectively. An AJCCTRG grading criterion was used for TRG. Correlation analysis between radiographic regression and TRG was performed by using Spearman grade correlation analysis. The KaplanMeier method was used for survival analysis. 
ResultsThe efficacy and adverse reactions were evaluated in 6 patients. The total treatment cycle of chemotherapy of 6 patients was 42， and the median treatment cycle was 6 （314 cycles）. Three cases of PR and 3 cases of SD were observed. One case of TRG 2 and 5 cases of TRG 3 were observed. There was no correlation between TRG and imaging findings （r=0131， P=0805）. The major treatmentrelated side effects including leucopenia， neutropenia， nausea， vomiting， fatigue and etc， were mainly in grade 12. The overall survival was 100274 months with a median overall survival of 255 months. 
ConclusionThere was inconsistency in TRG and imaging findings after neoadjuvant chemotherapy for resectable patients initially considered as unresectable colorectal cancer with liver metastases. The inconsistency was related to TNM stage， radiotherapy and pathology technique.

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