{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T02:37:36Z","timestamp":1786502256906,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T00:00:00Z","timestamp":1578268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The survival benefit of lymphadenectomy among patients with gallbladder cancer (GBC) remains poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent resection for GBC between 2000 and 2015 were identified from a US multi\u2010institutional database. The therapeutic index (LNM rate multiplied by 3\u2010year overall survival [OS]) was determined to assess the survival benefit of lymphadenectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 449 patients, less than half had LNM (N\u2009=\u2009183, 40.8%). The median number of evaluated and metastatic lymph nodes (LNs) was 3 (interquartile range [IQR]: 1\u20106) and 1 (IQR: 0\u20101), respectively. 3\u2010year OS among patients with LNM in the entire cohort was 26.8%. The therapeutic index was lower among patients with T4 (5.9) or T1 (6.0) tumors as well as carbohydrate antigen (CA19\u20109) \u2265200\u2009UI\/mL (6.0). Of note, a therapeutic index difference \u226510 was noted relative to CA19\u20109 (&lt;200: 18.7 vs \u2265200: 6.0), American Joint Committee on Cancer T Stage (T1: 6.0 vs T2: 17.8 vs T4: 5.9) and number of LNs examined (1\u20102: 6.9 vs \u22656: 16.9). Concomitant common bile duct resection was not associated with a higher therapeutic index among patients with either T2 or T3 disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Certain clinicopathological factors including T1 or T4 tumor and CA19\u20109 \u2265200\u2009UI\/mL were associated with a low therapeutic index. Resection of six or more LNs was associated with a meaningful therapeutic index benefit among patients with LNM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25825","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T06:19:38Z","timestamp":1578377978000},"page":"503-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Survival benefit of lymphadenectomy for gallbladder cancer based on the therapeutic index: An analysis of the US extrahepatic biliary malignancy consortium"],"prefix":"10.1002","volume":"121","author":[{"given":"Kota","family":"Sahara","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center Columbus Ohio"},{"name":"Department of Gastroenterological Surgery Yokohama City University School of Medicine Yokohama 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