{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:31:10Z","timestamp":1788964270232,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"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":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to examine the presentation, treatment, and long\u2010term outcomes of patients with gallbladder carcinoma (GBC) managed in a surgical unit of an Australian tertiary referral hospital of a 19\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of prospectively collected data of patients with GBC managed in the Royal North Shore Upper GI Surgical department from October 1999 to March 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 104 patients with GBC were identified: 36 patients underwent palliative treatment, 61 patients with gallbladder adenocarcinoma underwent resection with curative intent. Seven patients were excluded. \u2018Simple cholecystectomy\u2019 was undertaken in eight patients, \u2018standard radical cholecystectomy\u2019 in 37 and \u2018extended radical resection\u2019 in 16. The median survival in these patients was 35\u2009months (95% confidence interval (CI) 21.29\u201355.10), with a median follow up of 60\u2009months (95% CI 38.18\u201378.39). This compares with an overall median survival of only 4.00\u2009months (95% CI 2.79\u20136.24) in patients who did not undergo a potentially curative resection. Independent predictors of poor long\u2010term survival included an elevated preoperative serum tumour marker, advanced tumour stage (T3\/T4) or node positive disease (N1\/N2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The biology and stage of GBC at presentation are major factors in determining patient outcome. There is a need for better pre\u2010 and post\u2010operative predictors to improve risk stratification, and these are likely to be in the form of molecular markers. Although the focus of surgery should be to ensure an R0 resection, patients with advanced stage disease need to be carefully selected for surgical intervention, and ideally should be managed by a multidisciplinary team in a specialist centre.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16663","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T22:18:29Z","timestamp":1613859509000},"page":"603-608","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Gallbladder carcinoma outcomes in an Australian tertiary referral hospital"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6509-8390","authenticated-orcid":false,"given":"Marianne F. T.","family":"Wietsma","sequence":"first","affiliation":[{"name":"Department of Surgery Radboud University Medical Centre  Nijmegen Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Molloy","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazim","family":"Bhimani","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal North Shore Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2743-8128","authenticated-orcid":false,"given":"Elise A. 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