{
  "abstract": "Background While curative-intent resection for gallbladder cancer (GBC) is being increasingly performed in elderly patients, perioperative morbidity and long-term oncological outcomes in this population remain unclear.Methods Consecutive patients with GBC who underwent curative-intent resection (2016–2020) were identified from a multicentre database and stratified as elderly (>70 years) or younger (≤70 years). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to minimise selection bias. The outcomes compared included overall survival (OS), cancer-specific survival (CSS) and short-term outcomes. Logistic regression was used to identify risk factors for major morbidity and Cox regression was used for CSS, with the Fine-Gray competing risk model further applied to account for non-cancer-related death in the analysis of CSS.Results Among the 575 patients enrolled, 432 were younger and 143 were elderly. After 1:1 PSM and IPTW, elderly patients had significantly higher 90-day major morbidity rates than younger patients (p=0.029 and p=0.010, respectively), but also demonstrated better CSS in both cohorts (p=0.038 and p<0.001, respectively). OS was significantly longer in elderly patients only after PSM (p<0.001), with no significant difference after IPTW (p=0.684). Multi-adjusted analysis confirmed that advanced age was an independent risk factor for major morbidities (original cohort: OR 1.71 (95% CI 1.12 to 2.59); PSM: OR 1.88 (95% CI 1.08 to 3.30); IPTW: OR 1.83 (95% CI 1.17 to 2.82)) but was associated with longer CSS (original cohort: HR 0.65 (95% CI 0.44 to 0.97); PSM: HR 0.29 (95% CI 0.18 to 0.45); IPTW: HR 0.62 (95% CI 0.42 to 0.90); Fine-Gray model: HR 0.34 (95% CI 0.30 to 0.39)).Conclusion Despite a higher risk of major postoperative morbidity, advanced age itself might not be considered a contraindication for curative-intent resection. Selected elderly patients with GBC may achieve superior CSS compared to their younger counterparts.",
  "authors": [
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China",
        "Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi, China"
      ],
      "name": "Yu Pan"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Chun-Yue Ye"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China",
        "Department of General Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, Gansu, China"
      ],
      "name": "Peng Zhao"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Hai-Su Dai"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Yan Jiang"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Yu-Cheng Huang"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Cheng Chen"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Yu-Le Luo"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Jun-Jie Ding"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi, China"
      ],
      "name": "Rui Ding"
    },
    {
      "affiliations": [
        "Department of General Surgery, Lanzhou University First Affiliated Hospital, Lanzhou, Gansu, China"
      ],
      "name": "Ping Yue"
    },
    {
      "affiliations": [
        "Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China"
      ],
      "name": "Fan Huang"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China"
      ],
      "name": "Chao Yu"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, The First People’s Hospital of Jiujiang in Jiangxi Province, Jiujiang, Jiangxi, China"
      ],
      "name": "Zhao-Ping Wu"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China"
      ],
      "name": "Wei Chen"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, Henan Provincial Tumor Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Jin-Xue Zhou"
    },
    {
      "affiliations": [
        "Department of General Surgery, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"
      ],
      "name": "Wei Guo"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui, China"
      ],
      "name": "Da-Long Yin"
    },
    {
      "affiliations": [
        "Department of General Surgery, Third Affiliated Hospital of Zunyi Medical University, Zunyi, China"
      ],
      "name": "Wei Chen"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"
      ],
      "name": "Yi Zhu"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Jie Bai"
    },
    {
      "affiliations": [
        "Department of Health Statistics, College of Military Preventive Medicine, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Yan-Qi Zhang"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University East Campus, Xi’an, Shaanxi, China"
      ],
      "name": "Dong Zhang"
    },
    {
      "affiliations": [
        "National Teaching Demonstration Center, School of Basic Medicine, Fourth Military Medical University, Xi’an, Shaanxi, China"
      ],
      "name": "Ya-Yun Wang"
    },
    {
      "affiliations": [
        "Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of the Air Force Medical University, Xi'an, Shaanxi, China"
      ],
      "name": "Yan-Ling Yang"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Zhi-Peng Liu"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Rui Guo"
    },
    {
      "affiliations": [
        "Department of Hepatobiliary Surgery, The First Affiliated Hospital of Army Medical University, Chongqing, China"
      ],
      "name": "Zhi-Yu Chen"
    },
    {
      "affiliations": [],
      "name": "The Biliary Surgery Branch of the Chinese Society of Digestive Surgery"
    }
  ],
  "title": "Long-term and short-term outcomes of curative-intent resection for elderly and younger patients with gallbladder carcinoma: a multicentre propensity score-matched cohort study",
  "uid": "b43b93f7-b439-5bae-a95a-9ef1f1caf7e4"
}