{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T20:26:13Z","timestamp":1770409573997,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2003,7,14]],"date-time":"2003-07-14T00:00:00Z","timestamp":1058140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2003,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background and Aims:\u2002<\/jats:bold> Gallbladder cancer is common in Pakistan and has an extremely poor prognosis. Treatment is primarily surgical. Chemotherapy is frequently used in patients with advanced disease. This study was performed to evaluate and compare the clinicopathological features and management of gallbladder cancer in Pakistani patients, with particular emphasis on factors that influence survival.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Two hundred and thirty\u2010three patients with histologically proven gallbladder cancer were studied. Information was prospectively collected on demographic features, clinical and laboratory findings at the time of presentation, influence of therapy, and survival. Data were analyzed to evaluate variables that influenced survival. Kaplan\u2013Meier analysis was used to calculate survival.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Most patients were women (77%). Mean age was 55\u2003years (\u00b111\u2003years). Fourteen per cent of females were nulliparous. Twenty\u2010six per cent had five or more children. Only 4% of patients had a documented history of typhoid fever. The majority (69%) had a history of symptomatic gallbladder disease. The commonest presenting symptom was pain (89%), followed by nausea and vomiting (52%), weight loss (42%), and jaundice (33%). One\u2010quarter of patients had a palpable abdominal mass. Most had abnormal hepatic function tests and 58% had elevated carcinoma embryonic antigen levels. Stage (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001), jaundice (<jats:italic>P<\/jats:italic>\u2003=\u20030.01) and palpable mass (<jats:italic>P<\/jats:italic>\u2003=\u20030.02) were statistically significant variables. However, on multivariate analysis, tumor node metastases (TNM) stage was the only factor influencing survival. Median survival of the patients was 44\u2003months for patients with stage I disease, 23\u2003months for stage II, 17\u2003months for stage III and 6\u2003months for stage IV.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> These data are comparable with those reported from other developing countries. Most patients presented at an advanced stage of disease and had an extremely poor prognosis. Systemic therapy did not provide any survival benefit. The TNM stage remains the most important factor influencing survival.<\/jats:p>","DOI":"10.1046\/j.1440-1746.2003.03066.x","type":"journal-article","created":{"date-parts":[[2003,7,14]],"date-time":"2003-07-14T13:35:37Z","timestamp":1058189737000},"page":"950-953","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinicopathological features and management of gallbladder cancer in Pakistan: A prospective study of 233 cases"],"prefix":"10.1111","volume":"18","author":[{"given":"IMTIAZ A","family":"MALIK","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,7,14]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.50.1.7"},{"key":"e_1_2_6_3_2","volume-title":"Cancer: Principles and Practice of Oncology","author":"Lotze MT","year":"1993"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981215)83:12<2618::AID-CNCR29>3.0.CO;2-H"},{"key":"e_1_2_6_5_2","first-page":"706","article-title":"Gallbladder cancer","volume":"115","author":"Serra I","year":"1987","journal-title":"Rev. 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