Tailored postoperative surveillance can significantly improve outcomes for colorectal liver metastases patients.

• Among 962 patients, isolated liver recurrence was most common (49.7%) within 5 months.
• Bilateral disease showed higher risk with R1 resection (20.9% vs. 14.4%) and greater modified tumor burden scores (8.1 vs. 3.4).

Surgeons should prioritize early, personalized follow-up, especially for high burden and bilateral disease.

• Intra-/extrahepatic multi-site recurrences peaked at 8 months, emphasizing the need for ongoing assessment.