{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T07:27:25Z","timestamp":1762327645671,"version":"build-2065373602"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Considerable variability exists among liver surgeons in assessing resectability and local treatment planning of initially unresectable colorectal cancer liver-only metastases (CRLM). This study analysed short-term and survival outcomes of one-stage versus two-stage surgery for CRLM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with initially unresectable CRLM were included from the phase 3 CAIRO5 study. In patients in whom both one-stage and two-stage approaches were suggested by individual panel surgeons, these approaches were compared. The study population includes only patients for whom both approaches were discussed by the panel surgeons. Overall survival curves were estimated with the Kaplan\u2013Meier method and compared with the two-sided stratified log-rank test. Other surgical and postoperative outcomes were compared using a two-sample t test and Pearson\u2019s \u03c72 test or Fisher\u2019s exact test, as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Local surgeons planned one-stage versus two-stage surgery in 53 versus 51 patients, respectively. In the one-stage versus two-stage surgery groups, the median age was 59 (interquartile range (i.q.r.) 52\u201369) versus 59 (i.q.r. 53\u201368) years, respectively, and the median number of CRLM was 9 (i.q.r. 6.5\u201313) versus 10 (i.q.r. 7.5\u201314), respectively. Median overall survival was 46.5 versus 34.0 months (HR 0.61; 95% confidence interval 0.38 to 0.99; P = 0.043) with planned one-stage versus two-stage surgery, respectively. In one-stage versus two-stage surgery, Clavien\u2013Dindo grade \u2265 3 complications occurred in 11 versus 13 patients (P = 0.567), portal vein embolization was performed in 2 versus 41 patients (P &amp;lt; 0.001), and local treatment was complete (R0\/R1 resection or ablation of all CRLM) in 52 versus 29 patients (P &amp;lt; 0.001), respectively. Major liver resection was performed in 19 versus 28 patients with complete planned one-stage versus two-stage surgery, respectively, with a corresponding 32 versus 12 patients undergoing ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One-stage surgery with\/without ablation appears to be the optimal treatment approach for patients with initially unresectable CRLM for whom both one- and two-stage approaches are considered. Nonetheless, two-stage surgery remains vital for complex CRLM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraf125","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T11:25:33Z","timestamp":1756725933000},"source":"Crossref","is-referenced-by-count":0,"title":["One-stage\n                    <i>versus<\/i>\n                    two-stage surgery for initially unresectable colorectal cancer liver metastases: post hoc analysis of the CAIRO5 trial"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0225-5456","authenticated-orcid":false,"given":"Marinde J G","family":"Bond","sequence":"first","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Bolhuis","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, The Netherlands Cancer Institute , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martinus J","family":"van Amerongen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sint Maartenskliniek , Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiery","family":"Chapelle","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Transplantation, and Endocrine Surgery, Antwerp University Hospital , Antwerp ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald M","family":"van Dam","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Centre , Maastricht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc R W","family":"Engelbrecht","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam UMC , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael F","family":"Gerhards","sequence":"additional","affiliation":[{"name":"Department of Surgery, OLVG , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8293-6002","authenticated-orcid":false,"given":"Dirk J","family":"Gr\u00fcnhagen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"van Gulik","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC , Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Surgery, Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radboud University Medical Centre , Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koert P","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Centre Groningen , Groningen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geert","family":"Kazemier","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC , Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Surgery, Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joost M","family":"Klaase","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Centre Groningen , Groningen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels F M","family":"Kok","sequence":"additional","affiliation":[{"name":"Department of Surgery, Netherlands Cancer Institute , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter K G","family":"Leclercq","sequence":"additional","affiliation":[{"name":"Department of Surgery, M\u00e1xima Medical Centre , Veldhoven ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike S L","family":"Liem","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medical Spectrum Twente , Enschede ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krijn P","family":"van Lienden","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sint Antonius Hospital , Nieuwegein ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I Quintus","family":"Molenaar","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre Utrecht, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gijs A","family":"Patijn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Isala Hospital , Zwolle ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjen M","family":"Rijken","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amphia Hospital , Breda ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theo M","family":"Ruers","sequence":"additional","affiliation":[{"name":"Department of Surgery, Netherlands Cancer Institute , Amsterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9980-8613","authenticated-orcid":false,"given":"Cornelis","family":"Verhoef","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute , Rotterdam ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6773-9668","authenticated-orcid":false,"given":"Johannes H W","family":"de Wilt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboud University Medical Centre , Nijmegen ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M","family":"May","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelis J A","family":"Punt","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University , Utrecht ,","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3980-4634","authenticated-orcid":false,"given":"Rutger-Jan","family":"Swijnenburg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC , Amsterdam ,","place":["the Netherlands"]},{"name":"Department of Surgery, Cancer Center Amsterdam , Amsterdam ,","place":["the 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