Primary Objective:~• To assess 1-year recurrence-free survival rate following liver resection of CLM with curative intent among ctDNA-negative patients who receive risk-stratified postoperative chemotherapy~Secondary Objectives:~To assess recurrence-free survival following liver resection of CLM with curative intent among ctDNA-positive patients~To assess overall survival following liver resection among ctDNA-negative and ctDNA-positive patients~To evaluate the proportion of ctDNA-negative at 1-year post-resection~To compare survival of ctDNA-negative patients undergoing ctDNA-guided postoperative chemotherapy to historical controls~To evaluate proportion of patients in each arm who change chemotherapy in response to ctDNA measurement~To delineate the pattern of disease recurrence~To assess ctDNA sensitivity and specificity for predicting disease recurrence~To evaluate MDASI-GI during the course of postoperative therapy~To evaluate and correlate patient molecular subtypes and characterization of tumor biologic factors that are associated with ctDNA detection~To evaluate surgery-related adverse events occurring up to 90 days after surgery, and chemo-related adverse events occurring up to 30 days after the last dose of chemotherapy~Outcome Measures:~Primary:~• Recurrence-free survival at 1-year post-hepatectomy among ctDNA-negative patients~Secondary:~Recurrence-free survival at 1-year post-hepatectomy among ctDNA-positive patients~Overall survival (OS) among ctDNA-negative and ctDNA-positive patients~ctDNA-negativity at 1-year post-resection~Proportion of patients in each group with chemotherapy regimen change in response to ctDNA dynamics~Pattern of disease recurrence (i.e., liver, systemic, salvageable vs. unsalvageable)~ctDNA sensitivity/specificity for recurrent disease overall by timepoint~MDASI-GI at clinic visits during course of postoperative therapy~Tumor radiologic, histologic, and molecular profiling and correlative characterization based upon ctDNA detection~Adverse events
To determine if the detection of ctDNA after surgical resection of CLM can stratify patients into high and low-risk cohorts for early disease recurrence in order to inform post-operative adjuvant therapy.