{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:08:01Z","timestamp":1783901281538,"version":"3.55.0"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_raon-2021-0048_s_006\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A better appreciation of the course and factors that influence incidental gallbladder cancer (iGBC) is needed to develop treatment strategies aimed to improve outcomes. The purpose of the study was to determine the influence of residual disease in the liver and lymph nodes on overall survival in re-resected patients with iGBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2021-0048_s_007\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients undergoing radical re-resection for iGBC from January 2012 to December 2018 were retrospectively identified. Patients with a 5-year follow-up and submitted to complete resection with stage I, II and III disease were analysed. The influence of residual disease (RD) in liver and lymph nodes on survival was assessed using the Kaplan-Meier curves. In addition, the rest of the group was assessed based on type of primary\/secondary procedure, number of harvested lymph nodes and RD in liver and\/or lymph nodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2021-0048_s_008\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this retrospective study 48 out of 58 (83%) patients underwent re-resection. Among the group with a 5-year follow-up (re-operation between 2012\u20132014), 22 patients out of 28 (79%) were re-resected. Survival analysis showed that patients with no RD in the liver and lymph nodes had statistically significant better 5-year survival than those with RD. Comparing 5-year survival rate in patients with RD in the liver or lymph nodes against no RD group, patients with RD in the liver had statistically significantly worse 5-year survival, while lymph node metastases did not show any statistically significant different in 5-year survival. Besides, a statistically significant better prognosis was found in stage II disease compared to stage III, as expected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_raon-2021-0048_s_009\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The most important predictors of a 5-year survival in our study were RD in liver and stage of the disease. Lymph node metastases did not have any impact on the overall 5-year survival rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2021-0048","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T21:19:36Z","timestamp":1640294376000},"page":"208-215","source":"Crossref","is-referenced-by-count":4,"title":["Residual disease in lymph nodes has no influence on survival in patients with incidental gallbladder cancer \u2013 institution experience with literature review"],"prefix":"10.2478","volume":"56","author":[{"given":"Mihajlo","family":"\u0110okic","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary Surgery and Liver Transplantation, Department of Abdominal Surgery, University Medical Center Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Stupan","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Surgery and Liver Transplantation, Department of Abdominal Surgery, University Medical Center Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Licen","sequence":"additional","affiliation":[{"name":"Nursing Department, Faculty of Health Sciences, University of Primorska , Izola , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaz","family":"Trotovsek","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary Surgery and Liver Transplantation, Department of Abdominal Surgery, University Medical Center Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"2026071212040013427_j_raon-2021-0048_ref_001","doi-asserted-by":"crossref","unstructured":"Goetze TO, Paolucci V. Benefits of reoperation of T2 and more advanced incidental gallbladder carcinoma. Ann Surg 2008; 247: 104-8. doi: 10.1097\/ SLA.0b013e318154bf5d","DOI":"10.1097\/SLA.0b013e318154bf5d"},{"key":"2026071212040013427_j_raon-2021-0048_ref_002","doi-asserted-by":"crossref","unstructured":"Sikora SS, Singh RK. Surgical strategies in patients with gallbladder cancer: nihilism to optimism. J Surg Oncol 2006; 93: 670-81. doi: 10.1002\/jso.20535","DOI":"10.1002\/jso.20535"},{"key":"2026071212040013427_j_raon-2021-0048_ref_003","doi-asserted-by":"crossref","unstructured":"Aloia TA, J\u00e1rufe N, Javle M, Maithel SK, Roa JC, Adsay V, et al. Gallbladder Cancer: expert consensus statement. HPB (Oxford) 2015; 17: 681-90. doi: 10.1111\/hpb.12444","DOI":"10.1111\/hpb.12444"},{"key":"2026071212040013427_j_raon-2021-0048_ref_004","doi-asserted-by":"crossref","unstructured":"Hueman MT, Vollmer CM, Pawlik TM. Evolving treatment strategies for gallbladder cancer. Ann Surg Oncol 2009; 16: 2101-15. doi: 10.1245\/s10434-009-0538-x","DOI":"10.1245\/s10434-009-0538-x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_005","doi-asserted-by":"crossref","unstructured":"Li B, Xu XX, Du Y, Yang HF, Li Y, Zhang Q, et al. Computed tomography for assessing resectability of gallbladder carcinoma: a systematic review and meta-analysis. Clin Imaging 2013; 37: 327-33. doi: 10.1016\/j.clinimag.2012.05.009","DOI":"10.1016\/j.clinimag.2012.05.009"},{"key":"2026071212040013427_j_raon-2021-0048_ref_006","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Fern\u00e1ndez A, G\u00f3mez-R\u00edo M, Medina-Ben\u00edtez A, Moral J V-D, Ramos-Font C, Ramia-Angel JM, et al. Application of modern imaging methods in diagnosis of gallbladder cancer. J Surg Oncol 2006; 93: 650-64. doi: 10.1002\/jso.20533","DOI":"10.1002\/jso.20533"},{"key":"2026071212040013427_j_raon-2021-0048_ref_007","doi-asserted-by":"crossref","unstructured":"Butte JM, Redondo F, Waugh E, Meneses M, Pruzzo R, Parada H, et al. The role of PET-CT in patients with incidental gallbladder cancer. HPB (Oxford) 2009; 11: 585-91. doi: 10.1111\/j.1477-2574.2009.00104.x","DOI":"10.1111\/j.1477-2574.2009.00104.x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_008","doi-asserted-by":"crossref","unstructured":"Kokudo N, Makuuchi M, Natori T, Sakamoto Y, Yamamoto J, Seki M, et al. Strategies for surgical treatment of gallbladder carcinoma based on information available before resection. Arch Surg 2003; 138: 741-50. doi: 10.1001\/archsurg.138.7.741","DOI":"10.1001\/archsurg.138.7.741"},{"key":"2026071212040013427_j_raon-2021-0048_ref_009","doi-asserted-by":"crossref","unstructured":"Goere D, Wagholikar GD, Pessaux P, Carr\u00e8re N, Sibert A, Vilgrain V, et al. Utility of staging laparoscopy in subsets of biliary cancers: laparoscopy is a powerful diagnostic tool in patients with intrahepatic and gallbladder carcinoma. Surg Endosc 2006; 20: 721-5. doi: 10.1007\/s00464-005-0583-x","DOI":"10.1007\/s00464-005-0583-x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_010","doi-asserted-by":"crossref","unstructured":"Pawlik TM, Gleisner AL, Vigano L, Kooby DA, Bauer TW, Frilling A, et al. Incidence of finding residual disease for incidental gallbladder carcinoma: implications for re-resection. J Gastrointest Surg 2007; 11: 1478-86; discussion 1486-7. doi: 10.1007\/s11605-007-0309-6","DOI":"10.1007\/s11605-007-0309-6"},{"key":"2026071212040013427_j_raon-2021-0048_ref_011","doi-asserted-by":"crossref","unstructured":"Dixon E, Vollmer CM, Sahajpal A, Cattral M, Grant D, Doig C, et al. An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center. Ann Surg 2005; 241: 385-94. Available at: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15729060","DOI":"10.1097\/01.sla.0000154118.07704.ef"},{"key":"2026071212040013427_j_raon-2021-0048_ref_012","doi-asserted-by":"crossref","unstructured":"Fuks D, Regimbeau JM, Le Treut Y-P, Bachellier P, Raventos A, Pruvot F-R, et al. Incidental gallbladder cancer by the AFC-GBC-2009 Study Group. World J Surg 2011; 35: 1887-97. doi: 10.1007\/s00268-011-1134-3","DOI":"10.1007\/s00268-011-1134-3"},{"key":"2026071212040013427_j_raon-2021-0048_ref_013","doi-asserted-by":"crossref","unstructured":"Butte JM, Waugh E, Meneses M, Parada H, De La Fuente HA. Incidental gallbladder cancer: analysis of surgical findings and survival. J Surg Oncol 2010; 102: 620-5. doi: 10.1002\/jso.21681","DOI":"10.1002\/jso.21681"},{"key":"2026071212040013427_j_raon-2021-0048_ref_014","doi-asserted-by":"crossref","unstructured":"Hari DM, Howard JH, Leung AM, Chui CG, Sim M-S, Bilchik AJ. A 21-year analysis of stage I gallbladder carcinoma: is cholecystectomy alone adequate? HPB (Oxford) 2013; 15: 40-8. doi: 10.1111\/j.1477-2574.2012.00559.x","DOI":"10.1111\/j.1477-2574.2012.00559.x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_015","doi-asserted-by":"crossref","unstructured":"Abramson MA, Pandharipande P, Ruan D, Gold JS, Whang EE. Radical resection for T1b gallbladder cancer: a decision analysis. HPB (Oxford) 2009; 11: 656-63. doi: 10.1111\/j.1477-2574.2009.00108.x","DOI":"10.1111\/j.1477-2574.2009.00108.x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_016","doi-asserted-by":"crossref","unstructured":"Butte JM, G\u00f6nen M, Allen PJ, D\u2019Angelica MI, Kingham TP, Fong Y, et al. The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB (Oxford) 2011; 13: 463-72. doi: 10.1111\/j.1477-2574.2011.00325.x","DOI":"10.1111\/j.1477-2574.2011.00325.x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_017","doi-asserted-by":"crossref","unstructured":"Maker A V., Butte JM, Oxenberg J, Kuk D, Gonen M, Fong Y, et al. Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol 2012; 19: 409-17. doi:10.1245\/s10434-011-1850-9","DOI":"10.1245\/s10434-011-1850-9"},{"key":"2026071212040013427_j_raon-2021-0048_ref_018","doi-asserted-by":"crossref","unstructured":"Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 2000; 87: 418-22. doi: 10.1046\/j.13652168.2000.01384.x","DOI":"10.1046\/j.1365-2168.2000.01384.x"},{"key":"2026071212040013427_j_raon-2021-0048_ref_019","doi-asserted-by":"crossref","unstructured":"Jensen EH, Abraham A, Jarosek S, Habermann EB, Al-Refaie WB, Vickers SA, et al. Lymph node evaluation is associated with improved survival after surgery for early stage gallbladder cancer. Surgery 2009; 146: 706-11. doi: 10.1016\/j.surg.2009.06.056","DOI":"10.1016\/j.surg.2009.06.056"},{"key":"2026071212040013427_j_raon-2021-0048_ref_020","doi-asserted-by":"crossref","unstructured":"Meng H, Wang X, Fong Y, Wang ZH, Wang Y, Zhang ZT. Outcomes of radical surgery for gallbladder cancer patients with lymphatic metastases. Jpn J Clin Oncol 2011; 41: 992-8. doi: 10.1093\/jjco\/hyr072","DOI":"10.1093\/jjco\/hyr072"},{"key":"2026071212040013427_j_raon-2021-0048_ref_021","doi-asserted-by":"crossref","unstructured":"Shirai Y, Sakata J, Wakai T, Ohashi T, Ajioka Y, Hatakeyama K. Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodes. World J Surg Oncol 2012; 10: 87. doi: 10.1186\/1477-7819-10-87","DOI":"10.1186\/1477-7819-10-87"},{"key":"2026071212040013427_j_raon-2021-0048_ref_022","doi-asserted-by":"crossref","unstructured":"D\u2019Angelica M, Dalal KM, DeMatteo RP, Fong Y, Blumgart LH, Jarnagin WR. Analysis of the extent of resection for adenocarcinoma of the gallbladder. Ann Surg Oncol 2009; 16: 806-16. doi: 10.1245\/s10434-008-0189-3","DOI":"10.1245\/s10434-008-0189-3"},{"key":"2026071212040013427_j_raon-2021-0048_ref_023","doi-asserted-by":"crossref","unstructured":"Kurosaki I, Hatakeyama K, Minagawa M, Sato D. Portal vein resection in surgery for cancer of biliary tract and pancreas: special reference to the relationship between the surgical outcome and site of primary tumor. J Gastrointest Surg 2008; 12: 907-18. doi: 10.1007\/s11605-007-0387-5","DOI":"10.1007\/s11605-007-0387-5"},{"key":"2026071212040013427_j_raon-2021-0048_ref_024","doi-asserted-by":"crossref","unstructured":"Birnbaum DJ, Vigan\u00f2 L, Ferrero A, Langella S, Russolillo N, Capussotti L. Locally advanced gallbladder cancer: Which patients benefit from resection? Eur J Surg Oncol 2014; 40: 1008-15. doi: 10.1016\/j.ejso.2013.10.014","DOI":"10.1016\/j.ejso.2013.10.014"},{"key":"2026071212040013427_j_raon-2021-0048_ref_025","doi-asserted-by":"crossref","unstructured":"Ethun CG, Postlewait LM, Le N, Pawlik TM, Buettner S, Poultsides G, et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US extrahepatic biliary malignancy consortium. JAMA Surg 2017; 152: 143-9. doi: 10.1001\/jamasurg.2016.3642","DOI":"10.1001\/jamasurg.2016.3642"},{"key":"2026071212040013427_j_raon-2021-0048_ref_026","doi-asserted-by":"crossref","unstructured":"Cavallaro A, Piccolo G, Panebianco V, Menzo EL, Berretta M, Zanghi A, et al. Incidental gallbladder cancer during laparoscopic cholecystectomy: managing an unexpected finding. World J Gastroenterol 2012; 18: 4019-27. doi: 10.3748\/wjg.v18.i30.4019","DOI":"10.3748\/wjg.v18.i30.4019"},{"key":"2026071212040013427_j_raon-2021-0048_ref_027","doi-asserted-by":"crossref","unstructured":"Muratore A, Amisano M, Vigan\u00f2 L, Massucco P, Capussotti L. Gallbladder cancer invading the perimuscular connective tissue: results of reresection after prior non-curative operation. J Surg Oncol 2003; 83: 212-5. doi: 10.1002\/jso.10258","DOI":"10.1002\/jso.10258"},{"key":"2026071212040013427_j_raon-2021-0048_ref_028","doi-asserted-by":"crossref","unstructured":"Paolucci V, Neckell M, G\u00f6tze T. Das \u201eokkulte\u201d Gallenblasenkarzinom - CAE-S\/ CAMIC-Zentralregister. Zentralbl Chir 2003; 128: 309-12. doi: 10.1055\/s-2003-38795","DOI":"10.1055\/s-2003-38795"},{"key":"2026071212040013427_j_raon-2021-0048_ref_029","doi-asserted-by":"crossref","unstructured":"Negi SS, Singh A, Chaudhary A. Lymph nodal involvement as prognostic factor in gallbladder cancer: location, count or ratio? J Gastrointest Surg 2011; 15: 1017-25. doi: 10.1007\/s11605-011-1528-4","DOI":"10.1007\/s11605-011-1528-4"},{"key":"2026071212040013427_j_raon-2021-0048_ref_030","doi-asserted-by":"crossref","unstructured":"Ito H, Ito K, D\u2019Angelica M, Gonen M, Klimstra D, Allen P, et al. Accurate staging for gallbladder cancer: implications for surgical therapy and pathological assessment. Ann Surg 2011; 254: 320-5. doi: 10.1097\/ SLA.0b013e31822238d8","DOI":"10.1097\/SLA.0b013e31822238d8"},{"key":"2026071212040013427_j_raon-2021-0048_ref_031","doi-asserted-by":"crossref","unstructured":"Araida T, Higuchi R, Hamano M, Kodera Y, Takeshita N, Ota T, et al. Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: a multicenter study. Surg Today 2009; 39: 770-9. doi: 10.1007\/s00595-009-3960-6","DOI":"10.1007\/s00595-009-3960-6"},{"key":"2026071212040013427_j_raon-2021-0048_ref_032","doi-asserted-by":"crossref","unstructured":"Gil L, de Aretxabala X, Lendoire J, Duek F, Hepp J, Imventarza O. Incidental gallbladder cancer: How residual disease affects outcome in two referral HPB centers from South America. World J Surg 2019; 43: 214-20. doi: 10.1007\/s00268-018-4762-z","DOI":"10.1007\/s00268-018-4762-z"},{"key":"2026071212040013427_j_raon-2021-0048_ref_033","doi-asserted-by":"crossref","unstructured":"Butte JM, Kingham TP, G\u00f6nen M, D\u2019Angelica MI, Allen PJ, Fong Y et al. Residual disease predicts outcomes after definitive resection for incidental gallbladder cancer. J Am Coll Surg 2014; 219: 416-29. doi:1 0.1016\/j.jamcoll-surg.2014.01.069","DOI":"10.1016\/j.jamcollsurg.2014.01.069"}],"container-title":["Radiology and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/raon-2021-0048","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T23:18:40Z","timestamp":1783898320000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/raon-2021-0048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":33,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,12,22]]},"published-print":{"date-parts":[[2021,12,22]]}},"alternative-id":["10.2478\/raon-2021-0048"],"URL":"https:\/\/doi.org\/10.2478\/raon-2021-0048","relation":{},"ISSN":["1581-3207"],"issn-type":[{"value":"1581-3207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]}}}