Secondary cytoreductive surgery with hyperthermic intraperitoneal chemotherapy improves survival for select patients with recurrent colorectal cancer peritoneal metastases.

• Patients undergoing secondary surgery had an overall survival of 51.0 months compared to 24.0 months for those with initial treatment alone.
• No difference in postoperative complications was observed between initial and secondary procedures.

Consider secondary surgery for well-selected patients to potentially enhance outcomes after recurrence.

• Patients undergoing secondary treatment had similar survival to those receiving initial surgery (27.0 months vs. 24.0 months).