{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:45:19Z","timestamp":1753875919792,"version":"3.41.2"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004801","name":"ADP","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Treatment outcomes of incidental gallbladder cancer generally stem from tertiary referral centres, while many patients are initially diagnosed and managed in secondary care centres. Referral patterns of patients with incidental gallbladder cancer are poorly reported. This study aimed to evaluate incidental gallbladder cancer treatment in secondary centres, rates of referral to tertiary centres and its impact on survival.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medical records of patients with incidental gallbladder cancer diagnosed between 2000 and 2019 in 27 Dutch secondary centres were retrospectively reviewed. Patient characteristics, surgical treatment, tumour characteristics, referral pattern and survival were assessed. Predictors for overall survival were determined using multivariable Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 382 patients with incidental gallbladder cancer were included. Of 243 patients eligible for re-resection (pT1b\u2013pT3, M0), 131 (53.9%) were referred to a tertiary centre. The reason not to refer, despite indication for re-resection, was not documented for 52 of 112 non-referred patients (46.4%). In total, 98 patients underwent additional surgery with curative intent (40.3%), 12 of these in the secondary centre. Median overall survival was 33 months (95% c.i. 24 to 42 months) in referred patients versus 17 months (95% c.i. 3 to 31 months) in the non-referred group (P = 0.019). Referral to a tertiary centre was independently associated with improved survival after correction for age, ASA classification, tumour stage and resection margin (HR 0.60, 95% c.i. 0.38 to 0.97; P = 0.037).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Poor incidental gallbladder cancer referral rates were associated with worse survival. Age, performance status, resection margin or tumour stage should not preclude referral of a patient with incidental gallbladder cancer to a tertiary centre.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae013","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T20:12:12Z","timestamp":1711051932000},"source":"Crossref","is-referenced-by-count":1,"title":["Referral rate of patients with incidental gallbladder cancer and survival: outcomes of a multicentre retrospective study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-9629","authenticated-orcid":false,"given":"Mike","family":"van Dooren","sequence":"first","affiliation":[{"name":"Department of Surgery, Radboudumc , Nijmegen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise A J","family":"de Savornin Lohman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboudumc , Nijmegen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel S","family":"van der Post","sequence":"additional","affiliation":[{"name":"Department of Pathology, Radboudumc , Nijmegen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8233-1505","authenticated-orcid":false,"given":"Joris I","family":"Erdmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centers , Amsterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3320-7185","authenticated-orcid":false,"given":"Frederik J H","family":"Hoogwater","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Transplant Surgery, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-6973","authenticated-orcid":false,"given":"Bas","family":"Groot Koerkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmusmc , Rotterdam , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter B","family":"van den Boezem","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboudumc , Nijmegen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R","family":"de Reuver","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboudumc , Nijmegen , The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"2024052815254659400_zrae013-B1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.suc.2014.01.009","article-title":"Gallbladder cancer","volume":"94","author":"Wernberg","year":"2014","journal-title":"Surg Clin North Am"},{"key":"2024052815254659400_zrae013-B2","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1177\/000313481708300721","article-title":"Pathologic and prognostic implications of incidental versus nonincidental gallbladder cancer: a 10-institution study from the United States extrahepatic biliary malignancy consortium","volume":"83","author":"Ethun","year":"2017","journal-title":"Am Surg"},{"key":"2024052815254659400_zrae013-B3","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1245\/s10434-019-08074-4","article-title":"Re-resection in incidental gallbladder cancer: survival and the incidence of residual disease","volume":"27","author":"de Savornin Lohman","year":"2020","journal-title":"Ann Surg Oncol"},{"key":"2024052815254659400_zrae013-B4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.6004\/jnccn.2021.0022","article-title":"Hepatobiliary cancers, version 2.2021, NCCN clinical practice guidelines in oncology","volume":"19","author":"Benson","year":"2021","journal-title":"J Natl Compr Canc Netw"},{"key":"2024052815254659400_zrae013-B5"},{"key":"2024052815254659400_zrae013-B6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1308\/003588414X14055925060073","article-title":"Implications of the index cholecystectomy and timing of referral for radical resection of advanced incidental gallbladder cancer","volume":"97","author":"Tsirlis","year":"2015","journal-title":"Ann R Coll Surg Engl"},{"key":"2024052815254659400_zrae013-B7","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1111\/hpb.12189","article-title":"Management of incidental and suspicious gallbladder cancer: focus on early referral to a tertiary centre","volume":"16","author":"Yip","year":"2014","journal-title":"HPB (Oxford)"},{"key":"2024052815254659400_zrae013-B8","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1007\/s00268-011-1134-3","article-title":"Incidental gallbladder cancer by the AFC-GBC-2009 study group","volume":"35","author":"Fuks","year":"2011","journal-title":"World J Surg"},{"key":"2024052815254659400_zrae013-B9","doi-asserted-by":"crossref","first-page":"2949","DOI":"10.1245\/s10434-021-09607-6","article-title":"Undertreatment of gallbladder cancer: a nationwide analysis","volume":"28","author":"Papageorge","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"2024052815254659400_zrae013-B10","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1245\/s10434-021-09761-x","article-title":"The undertreatment of gallbladder cancer: gaps in seeking, reaching, and receiving care","volume":"28","author":"Keilson","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"2024052815254659400_zrae013-B11","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1245\/s10434-018-7064-7","article-title":"National failure of surgical staging for T1b gallbladder cancer","volume":"26","author":"Vo","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"2024052815254659400_zrae013-B12","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"2024052815254659400_zrae013-B13","first-page":"19","article-title":"Pathology databanking and biobanking in The Netherlands, a central role for PALGA, the nationwide histopathology and cytopathology data network and archive","volume":"29","author":"Casparie","year":"2007","journal-title":"Cell Oncol"},{"volume-title":"American Society of Anesthesiologists Classification. StatPearls","year":"2020","author":"Doyle","key":"2024052815254659400_zrae013-B14"},{"author":"Castor","key":"2024052815254659400_zrae013-B15"},{"key":"2024052815254659400_zrae013-B16","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/hpb.12444","article-title":"Gallbladder cancer: expert consensus statement","volume":"17","author":"Aloia","year":"2015","journal-title":"HPB (Oxford)"},{"key":"2024052815254659400_zrae013-B17","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1002\/bjs.11205","article-title":"Management of incidental gallbladder cancer in a national cohort","volume":"106","author":"Lundgren","year":"2019","journal-title":"Br J Surg"},{"key":"2024052815254659400_zrae013-B18","volume-title":"AJCC Cancer Staging Manual","author":"Amin","year":"2017","edition":"8th ed"},{"key":"2024052815254659400_zrae013-B19","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/bjs.11035","article-title":"Systematic review of management of incidental gallbladder cancer after cholecystectomy","volume":"106","author":"S\u00f8reide","year":"2019","journal-title":"Br J Surg"},{"key":"2024052815254659400_zrae013-B20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1001\/jamasurg.2016.3642","article-title":"Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival","volume":"152","author":"Ethun","year":"2017","journal-title":"JAMA Surg"},{"key":"2024052815254659400_zrae013-B21","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.21873\/invivo.12372","article-title":"Incidental gallbladder cancer on cholecystectomy: strategy for re-resection of presumed benign diseases from a retrospective multicenter study by the Yokohama clinical oncology group","volume":"35","author":"Matsuyama","year":"2021","journal-title":"In Vivo"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/8\/2\/zrae013\/57951425\/zrae013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/8\/2\/zrae013\/57951425\/zrae013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T19:37:47Z","timestamp":1716925067000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zrae013\/7633087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zrae013","relation":{},"ISSN":["2474-9842"],"issn-type":[{"type":"electronic","value":"2474-9842"}],"subject":[],"published-other":{"date-parts":[[2024,4]]},"published":{"date-parts":[[2024,3,1]]},"article-number":"zrae013"}}