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The current study aimed to investigate predictive factors of survival outcomes and select candidates for local treatment for CRLM at first recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected retrospectively from CRLM patients who underwent hepatic resection and developed first recurrence between 2000 and 2019 at our institution.\u2028A nomogram predicting overall survival was established based on a multivariable Cox model of clinicopathologic factors. The predictive accuracy and discriminative ability of the nomogram were determined by the concordance index and calibration curve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 867 patients who underwent curative hepatic resection, 549 patients developed recurrence. Three hundred patients were evaluated and had resectable and liver-limited disease. Among them, repeat liver resection and percutaneous radiofrequency ablation were performed in 88 and 85 patients, respectively. The other 127 patients received only systemic chemotherapy. Multivariable analysis identified primary lymph node positivity, tumor size\u2009&gt;\u20093\u00a0cm, early recurrence, RAS gene mutation and no local treatment as independent risk factors for survival outcomes. Integrating these five variables, the nomogram presented a good concordance index of 0.707. Compared with patients who received only systemic chemotherapy, radical local treatment did not significantly improve survival outcomes (median OS: 21 vs. 15\u00a0months, p\u2009=\u20090.126) in the high-risk group (total score\u2009\u2265\u200913).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radical local treatment improved the survival of recurrent CRLM patients. The proposed model facilitates personalized assessments of prognosis for patients who develop first recurrence in the liver.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-021-01323-y","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T06:03:01Z","timestamp":1629093781000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Recurrent colorectal liver metastasis patients could benefit from repeat hepatic resection"],"prefix":"10.1186","volume":"21","author":[{"given":"Wei","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Ming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong-Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9854-2726","authenticated-orcid":false,"given":"Bao-Cai","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"issue":"1","key":"1323_CR1","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/SLA.0000000000001624","volume":"265","author":"U Leung","year":"2017","unstructured":"Leung U, Gonen M, Allen PJ, Kingham TP, DeMatteo RP, Jarnagin WR, D\u2019Angelica MI. 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The investigation project was examined and certified by the Ethics Committee of Beijing Cancer Hospital. The study was performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The manuscript does not contain any individual person's data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The manuscript has not been presented at a talk or poster meeting. We declare that we have\u00a0no financial and personal relationships with other people or organizations that could have inappropriately influenced our work, and there are\u00a0no professional or other personal interests of any nature or kind in any product, service and\/or company that could be construed.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"327"}}