Postoperative health-related quality of life (HR-QoL) significantly improves in patients undergoing hepatectomy for high-risk colorectal liver metastases if they remain disease-free.

• HR-QoL, as measured by the QLQ-C30, dropped by 14.6 points post-surgery but returned to baseline by 12 months.
• Patients with no evidence of disease (NED) showed marked improvement, reporting higher HR-QoL scores 24 months post-op compared to baseline.

Assessing HR-QoL is crucial for managing patient expectations and refining follow-up care; recurrence negatively impacts recovery outcomes.

• Those with cancer recurrence consistently reported lower HR-QoL scores than NED patients at all follow-ups.