{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:47:49Z","timestamp":1782409669833,"version":"3.54.5"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007154","name":"Wake Forest University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007154","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Clin Oncol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gallbladder cancer is rare with high mortality and limited treatments. Patients with IIIB disease (T1-3, N1, M0) are typically not offered resection and may receive palliative chemotherapy. This study evaluates survival of IIIB patients undergoing surgery with or without systemic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with stage IIIB gallbladder cancer who underwent curative-intent surgery were identified from the National Cancer Database (2004\u20132020). Outcomes were analyzed by chemotherapy sequence using Kaplan-Meier curves and Cox proportional hazards models. Lymphadenectomy type and margin status were also compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      409 patients were included. Mean age was 60 in neoadjuvant, 65 in adjuvant and 72 in no chemotherapy classes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The median overall survival (OS) in months was 33.8 (95% CI 23.8 - NA) in neoadjuvant, 22.6 (95% CI 19.8\u201327.2) in adjuvant and 9.4 (95% CI 7.3\u201314.3) in no chemotherapy groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Compared to adjuvant therapy, hazard ratios (HR) for OS were 0.76 (95% CI 0.46\u20131.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.29) for neoadjuvant and 1.87 (95% CI 1.45\u20132.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) for no chemotherapy. Age, tumor size, number of positive regional nodes, and positive margins (R1) were significant covariables. Regional lymphadenectomies were performed in 79%, 87%, and 84% for neoadjuvant, adjuvant, and no chemotherapy classes. R0 margins were obtained in 86%, 76%, and 81%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgery with systemic therapy should be considered in stage IIIB gallbladder cancer. Perioperative chemotherapy was associated with longer survival but occurred more in younger patients. Perioperative chemotherapy, particularly neoadjuvant, may benefit appropriately selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-03051-w","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:28:31Z","timestamp":1779985711000},"page":"1345-1354","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative chemotherapy for clinical stage IIIB gallbladder cancer: a review of the National Cancer Database"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6820-0450","authenticated-orcid":false,"given":"Jennifer","family":"Wylie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grey","family":"Leonard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clancy","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Levine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perry","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"issue":"1","key":"3051_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/CEJ.0000000000000402","volume":"28","author":"V Jaruvongvanich","year":"2019","unstructured":"Jaruvongvanich V, Yang JD, Peeraphatdit T, Roberts LR (2019) The incidence rates and survival of gallbladder cancer in the USA. 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In accordance with institutional policy and federal regulations, the project was reviewed by the Wake Forest School of Medicine Institutional Review Board (IRB) and was determined to be exempt from full review due to the use of existing, de-identified data. The IRB waived the requirement for informed consent. All procedures were carried out in compliance with the ethical standards of the institutional research committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}