ArticleAnnals of surgical oncology2026
Occult Nodal Disease in Gallbladder Cancer: An International Multi-institutional Analysis and Preoperative Risk Stratification.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- ASO Author Reflections: Closing the Staging Gap in Gallbladder Cancer: Preoperative Risk Enrichment for Occult Nodal Disease.Annals of surgical oncology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAccurate preoperative nodal staging remains challenging in gallbladder cancer (GBC), and a substantial proportion of patients presumed to be clinically node-negative have nodal metastasis at surgery. This study aimed to quantify the burden of occult nodal disease (OND)-defined as pathologic node-positive disease among clinically node-negative patients-and to identify preoperative factors associated with OND.
methodsPatients who underwent upfront curative-intent resection with regional lymphadenectomy for GBC were identified from an international multi-institutional database. Among patients staged as clinically node-negative (cN0) on preoperative imaging, multivariable logistic regression was used to identify preoperative predictors of OND. CA19-9 and the systemic immune-inflammation index (SII) were log-transformed for modeling purposes.
resultsAmong 187 patients, 142 (75.9%) were classified as cN0 preoperatively, among whom 47 (33.1%) had OND on final pathology. On multivariable analysis, higher ln(SII) (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.05-2.86), higher ln(CA19-9) (OR 1.30, 95% CI 1.12-1.53), and preoperative jaundice (OR 3.68, 95% CI 1.21-11.76) were independently associated with OND. The observed OND rate increased stepwise with the number of elevated preoperative markers (SII > 890.2, CA19-9 > 37 U/mL, and jaundice): 17.1% with 0 markers, 44.8% with 1 marker, and 73.6% with 2-3 markers.
conclusionsOND was present in approximately one-third of clinically node-negative GBC patients undergoing lymphadenectomy. Preoperative jaundice, elevated CA19-9, and elevated SII independently predicted OND and provided simple risk stratification. Incorporating these readily available markers into preoperative assessment may improve risk enrichment for OND and help guide additional staging and treatment sequencing.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.