{"entity":{"id":"paper-de-savornin-lohman-re-resection-incidental-gallbladder-cancer-aso-2020","kind":"paper","name":"Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease","aka":[],"tldr":"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.","summary":"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.","asOf":"2026-09-24","links":[{"label":"Ann Surg Oncol 2020","url":"https://doi.org/10.1245/s10434-019-08074-4"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31741109/"}],"tags":["gallbladder-evidence"],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["incidental-gallbladder-cancer","radical-cholecystectomy"],"trials":[],"people":[],"bottlenecks":["b-care-fragmentation"],"keyPapers":[],"journals":["annals-of-surgical-oncology"],"dependsOn":[],"notes":[],"journal":"Annals of Surgical Oncology","year":2020,"doi":"10.1245/s10434-019-08074-4","pmid":"31741109","authors":"de Savornin Lohman EAJ, van der Geest LG, de Bitter TJJ, et al.","paperType":"real-world","findings":["24 percent (110 of 463) of incidental gallbladder cancers were re-resected, after a median of 66 days.","Residual disease in 35 percent, most often lymph nodes (23 percent); R0 in 92 percent.","Median overall survival 52.6 months with re-resection vs 13.7 months without."],"whatItMeans":"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.","caveats":["Unmatched comparison; patients selected for re-resection were fitter and had less advanced disease.","Registry data; reasons for not re-resecting were not captured."],"changedPractice":false,"participants":463},"route":"/key-papers/paper-de-savornin-lohman-re-resection-incidental-gallbladder-cancer-aso-2020/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"incidental-gallbladder-cancer","kind":"cancer","name":"Incidental gallbladder cancer (found after cholecystectomy)","route":"/cancers/incidental-gallbladder-cancer/"}],"term":[{"id":"radical-cholecystectomy","kind":"term","name":"Radical (extended) cholecystectomy","route":"/terms/radical-cholecystectomy/"}],"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"}],"journal":[{"id":"annals-of-surgical-oncology","kind":"journal","name":"Annals of surgical oncology","route":"/journals/annals-of-surgical-oncology/"}],"roadmap":[{"id":"gallbladder-cancer-roadmap","kind":"roadmap","name":"Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials","route":"/roadmaps/gallbladder-cancer-roadmap/"}],"idea":[{"id":"idea-gbc-national-incidental-cancer-pathway","kind":"idea","name":"A national incidental gallbladder cancer pathway: histology for every gallbladder, referral within two weeks, re-resection by eight","route":"/ideas/idea-gbc-national-incidental-cancer-pathway/"}]}}