{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T20:04:17Z","timestamp":1784145857260,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The peritoneum is the third most prevalent location for metastases of colorectal cancer. In patients with resectable disease, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS\u2010HIPEC) is the preferred treatment in the Netherlands, achieving median overall survival (OS) of 36\u201342 months. However, during explorative laparotomy, CRS\u2010HIPEC may appear unfeasible. Evidence on how such non\u2010therapeutic laparotomies affect prognosis is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included all non\u2010therapeutic laparotomies performed between 01 and 01\u20102010 and 01\u201001\u20102022 in two Dutch tertiary HIPEC\u2010centers. Patient, tumor and treatment characteristics, postoperative morbidity, and survival outcomes were analyzed and compared to existing literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 108 patients underwent a non\u2010therapeutic laparotomy (discontinued CRS\u2010HIPEC). The main reason was that peritoneal disease was too extensive (56%). Severe postoperative complications (Clavien\u2013Dindo \u2265\u20093) occurred in 9%. Following a non\u2010therapeutic procedure, 55% of patients received tumor\u2010directed palliative treatment. Median OS of the entire cohort was 6.5 months (95% CI 5.1\u20138.0). Palliative systemic therapy was the only factor significantly associated with improved OS (12.6 vs. 2.9 months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010therapeutic laparotomies are associated with decreased survival in patients with extensive peritoneal metastases. Reducing their occurrence is essential. Advances in diagnostic modalities, including MRI, FAPI\u2010PET, artificial intelligence, and developments in bidirectional treatments, may improve preoperative selection and offer alternative therapeutic options. Further research is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70240","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:20:14Z","timestamp":1777530014000},"page":"843-851","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Negative Impact of a Non\u2010Therapeutic Laparotomy in Patients With Inoperable Colorectal Peritoneal Metastases"],"prefix":"10.1002","volume":"133","author":[{"given":"Teun van den","family":"Heuvel","sequence":"first","affiliation":[{"name":"Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences Maastricht the Netherlands"},{"name":"Department of Surgery Catharina Hospital Eindhoven the Netherlands"},{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organization Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars van","family":"Kesteren","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Nienhuijs","sequence":"additional","affiliation":[{"name":"Department of Surgery Catharina Hospital Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"Burger","sequence":"additional","affiliation":[{"name":"Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences Maastricht the Netherlands"},{"name":"Department of Surgery Catharina Hospital Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tineke","family":"Buffart","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cancer Center Amsterdam Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurriaan","family":"Tuynman","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam University Medical Center Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignace De","family":"Hingh","sequence":"additional","affiliation":[{"name":"Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences Maastricht the Netherlands"},{"name":"Department of Surgery Catharina Hospital Eindhoven the Netherlands"},{"name":"Department of Research and Development Netherlands Comprehensive Cancer Organization Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31785"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10585-015-9719-0"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.11.135"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10190-z"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clcc.2020.06.010"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4387-5"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-3145-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7800-2-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.9285"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-014-4148-x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-12969-0"},{"key":"e_1_2_7_14_1","unstructured":"F. 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