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In the Dutch national registry only one in four people with a chance-found gallbladder cancer had the recommended second operation; those who did lived about four times longer, and a third of them had cancer left behind that the operation removed.
Netherlands Cancer Registry study of 463 patients with incidental gallbladder cancer; 110 (24 percent) underwent re-resection after a median of 66 days, and their pathology reports were reviewed. Residual disease was present in 35 percent, most often in lymph nodes (23 percent); R0 resection was achieved in 92 percent. Median overall survival was 13.7 months (95 percent CI 11.6 to 15.6) without re-resection and 52.6 months (36.3 to 68.8) with it. Residual disease was the only significant prognostic factor after re-resection and was predicted by pT and pN stage. The authors note re-resection remains infrequent and is often performed after the optimal interval.
A whole-country picture of the gap between guideline and practice: three quarters of eligible patients never reached the second operation. The survival difference is confounded by selection but the residual disease rate is not.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Gallbladder cancer and the tag gallbladder-evidence.
Shares A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Annals of surgical oncology, Radical (extended) cholecystectomy, Gallbladder cancer and the tag gallbladder-evidence.