Surgery for colorectal liver metastases after chemotherapy failure can offer survival benefits.

• Patients with progressive disease underwent hepatectomy showed a 5-year overall survival rate of 42.7%.
• This is lower than those with controlled disease (62.0% in complete/partial response and 55.5% in stable disease, p<0.001).
• However, resected progressive disease patients had better survival (46.5%) than non-resected partial response patients (11.4%, p<0.001).
• Preoperative carcinoembryonic antigen (CEA) ≥100 ng/ml and metachronous liver metastases are key risk factors for poor outcomes.

Consider surgical options cautiously in progressive disease cases.