{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:46:28Z","timestamp":1791863188829,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"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":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Among patients with colorectal cancer, the liver is the most common site of metastases and is frequently the only site of disease. Curative intent resection offers the best chance for survival; however, access to surgery and outcomes may be influenced by social drivers of health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the 2022 National Cancer Database, we identified adults with colorectal liver metastases (CRLM) without extrahepatic spread. Patients were categorized into four surgical groups: combined primary and liver resection, liver\u2010only resection, primary\u2010only resection, and no surgery. Demographic, socioeconomic, and clinical factors were compared, and multivariable logistic and Cox models were used to assess predictors of surgery and overall survival and mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 40,670 patients, 49.8% received no surgery, 32.8% underwent primary\u2010only resection, 1.6% underwent liver\u2010only resection, and 15.8% underwent combined primary and liver resection. Combined resections were most common among younger, privately insured patients treated at academic centers in higher\u2010income and higher\u2010education regions (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median OS differed significantly by treatment: combined resection, 59.5 months; liver\u2010only, 41.5 months; primary\u2010only, 28.2 months; and no surgery, 13.8 months. Adjusted mortality was higher for primary\u2010only (HR 1.66), liver\u2010only (HR 1.71), and no surgery (HR 3.21) compared with combined resection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined primary and liver resection was associated with the longest survival and lowest mortality among patients with CRLM. Significant disparities in surgical treatment and survival were observed across key social drivers of health, underscoring the need to address inequities in access to comprehensive, curative\u2010intent care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70288","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:00:22Z","timestamp":1779188422000},"page":"236-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Social and Surgical Drivers of Survival in Colorectal Liver Metastases: An NCBD Analysis"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1539-0964","authenticated-orcid":false,"given":"Carson","family":"Cummings","sequence":"first","affiliation":[{"name":"School of Medicine Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Kim","sequence":"additional","affiliation":[{"name":"School of Medicine Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colton","family":"Taylor","sequence":"additional","affiliation":[{"name":"School of Medicine Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Chandler","sequence":"additional","affiliation":[{"name":"School of Medicine Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Riverside University Health System Moreno Valley California USA"},{"name":"Department of Surgery, Division of Surgical Oncology Loma Linda University Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Riverside University Health System Moreno Valley California USA"},{"name":"Department of Surgery, Division of Surgical Oncology Loma Linda University Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Wiafe","sequence":"additional","affiliation":[{"name":"School of Public Health Loma Linda University Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Loma Linda University Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Eguia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Loma Linda University Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21772"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.6130"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2024.114160"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2020.09.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3892\/or.2017.5531"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21812"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-020-03585-z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16132379"},{"key":"e_1_2_9_10_1","unstructured":"National Cancer Database. 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