RT Journal A1 McCahill L T1 TRends in presentation and survival for gallbladder cancer during a period of more than 4 decades—invited critique JF Archives of Surgery JO Archives of Surgery YR 2009 FD May 18 VO 144 IS 5 SP 447 OP 447 DO 10.1001/archsurg.2009.55 UL http://dx.doi.org/10.1001/archsurg.2009.55 AB In 1978, Piehler and Crichlow reviewed the dismal outcomes of patients with gallbladder cancer, reporting a 5-year survival rate of just 4.1%, including those with incidentally discovered gallbladder cancer.1 More than 30 years later, Konstantinidis and colleagues at Massachusetts General Hospital offer some new insights for the few patients who present with relatively early-stage disease. The results of this study add to a growing body of evidence that, for incidentally discovered gallbladder cancer, surgical reexploration with a planned major liver resection (segments V and IVA) and regional lymphadenectomy are indicated because most (50%-75%) patients with T1b, T2, and T3 gallbladder cancer will have additional disease identified at reexploration.