{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:56:17Z","timestamp":1789732577859,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Treatment guidelines on cytoreductive surgery (CRS) for metastatic colorectal cancer (mCRC) continue to have variability. This study investigated survival outcomes and utilization trends of CRS on mCRC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from the National Cancer Database with mCRC who received systemic chemotherapy 2004\u20132015 were categorized by colectomy, colectomy and metastasectomy (CRS), and no surgery (NS). Kaplan\u2013Meier analyses with inverse probability of treatment weighting (IPTW) were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 88\u2009593 patients in the study cohort, 39\u2009028 had a colectomy, 21\u2009462 CRS, and 28\u2009103 NS. CRS utilization increased from 33.1% (2004) to 38.3% (2015). CRS (aHR\u2009=\u20090.36) and colectomy (aHR\u2009=\u20090.47) were associated with significantly improved OS compared to NS. Median OS with IPTW remained longer in CRS versus colectomy versus NS (34.4 months vs. 26.7 vs. 13.2) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Patients who received hyperthermic intraperitoneal chemotherapy (HIPEC) had improved OS compared to non\u2010HIPEC patients (aHR\u2009=\u20090.55, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>National utilization of CRS for mCRC is steadily increasing and associated with improved OS, supporting the use of more aggressive surgical approaches in select patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.70012","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T06:25:20Z","timestamp":1750400720000},"page":"334-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Increasing Role for Cytoreductive Surgery in Metastatic Colorectal Cancer\u2014National Trends in the Era of More Effective Systemic Therapy"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4974-525X","authenticated-orcid":false,"given":"Stephanie","family":"Young","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Milgrom","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Goldfarb","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Bilchik","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Providence Saint John's Cancer Institute Santa Monica California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.7633"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.5278"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25431"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102840"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1098-2388(199804\/05)14:3<254::aid-ssu10>3.0.co;2-u"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10049-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","unstructured":"Group CCW \u201cThe Chicago Consensus on Peritoneal Surface Malignancies: Management of Colorectal Metastases \u201dCancer126 no. 11 (June2020): 2534\u20132540 https:\/\/doi.org\/10.1002\/cncr.32874.","DOI":"10.1002\/cncr.32874"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0029"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.6905"},{"key":"e_1_2_8_11_1","unstructured":"G.Ridgeway D. 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