Resection of solitary colorectal liver metastases leads to excellent long-term survival, but outcomes depend on lymph node status and tumor size.

• Median overall survival is 10 years; 52% remain recurrence-free at 3 years.
• Salvage therapy for 51% of recurrences boosts overall survival significantly (5.89 years vs. 2.24 years; p<0.001).
• Patients with more than three positive lymph nodes face worse outcomes (HR 2.19).

Adjuvant hepatic artery infusion chemotherapy enhances survival and decreases liver recurrence.