Gallbladder cancer

被引：39
作者：
Misra S. [1 ]
Chaturvedi A. [1 ]
Misra N.C. [1 ]
机构：
[1] Department of Surgical Oncology, King George's Medical University, Lucknow, UP 226 007
来源：
Current Treatment Options in Gastroenterology | 2006年 / 9卷 / 2期
关键词：
Gemcitabine; Capecitabine; Biliary Tract; Gallbladder Cancer; Tumor Node Metastasis;
D O I：
10.1007/s11938-006-0028-1
中图分类号：
学科分类号：
摘要：
Gallbladder cancer (GBC) is the most common malignancy of the biliary tract and the fifth most common gastrointestinal (GI) cancer. In addition to global inter-country variations in incidence, large racial and ethnic variations have been noted within countries. High incidence rates of GBC have been described in North India, for example. Despite the fact that the precise etiology of GBC is poorly understood, a strong association between GBC and cholelithiasis exists. Most GBC presents clinically as advanced disease with unfavorable prognosis and poor response to treatment. A small but increasing proportion of cases of incidental GBC detected during or after cholecystectomy is also being seen. Such patients are generally in an earlier stage of disease and are potentially more curable by a completion radical cholecystectomy, which is especially indicated for patients whose disease is stage pT1b or beyond. Radical surgery is the mainstay of curative intent treatment for GBC. When feasible, extended or radical cholecystectomy is the standard treatment for resectable GBC. Patients with advanced stage III or IV disease may undergo more complex, high-risk, and morbid extended resections such as hepatopancreaticoduodenectomy. We believe that these procedures should be performed only in selected patients at centers specializing in these resections. Patients not fit for such major resection or found unresectable on imaging or exploration are usually offered palliative treatment. This may be in the form of surgical palliation (eg, palliative bypass for gastric outlet, bowel, or biliary tract obstruction), endoscopic biliary stenting (for obstructive jaundice), or palliative chemotherapy. Chemotherapy for GBC is generally used in the palliative setting. Gemcitabine, cisplatin, 5-fluorouracil, mitomycin, and capecitabine are some of the effective agents. We have reported gratifying overall response rates of 55% with the combination of gemcitabine and cisplatin in patients with advanced GBC. Patients with advanced GBC and jaundice who undergo stenting followed by chemotherapy show response and survival rates similar to those who present without jaundice. Copyright © 2006 by Current Science Inc.
引用
收藏
页码：95 / 106
页数：11
相关论文
共 60 条
  • [41] Patt Y.Z., Jones Jr. D.V., Hoque A., Et al., Phase II trial of intravenous fluorouracil and subcutaneous interferon alfa-2b for biliary tract cancer, J Clin Oncol, 14, pp. 2311-2315, (1996)
  • [42] Gallardo J.O., Rubio B., Fodor M., Et al., A phase II study of gemcitabine in gallbladder carcinoma, Ann Oncol, 12, pp. 1403-1406, (2001)
  • [43] Scheithauer W., Review of gemcitabine in biliary tract carcinoma, Semin Oncol, 29, pp. 40-45, (2002)
  • [44] Lin M.H., Chen J.S., Chen H.H., Et al., A phase II trial of gemcitabine in the treatment of advanced bile duct and periampullary carcinomas, Chemotherapy, 49, pp. 154-158, (2003)
  • [45] Alberts S.R., Al-Khatib H., Mahoney M.R., Et al., Gemcitabine, 5-fluorouracil, and leucovorin in advanced biliary tract and gallbladder carcinoma: A North Central Cancer Treatment group phase II trial, Cancer, 103, pp. 111-118, (2005)
  • [46] Kuhn R., Hribaschek A., Eichelmann K., Et al., Outpatient therapy with gemcitabine and docetaxel for gallbladder, biliary, and cholangiocarcinomas, Invest New Drugs, 20, pp. 351-356, (2002)
  • [47] Stieler J.M., Roll L., Arning M., Et al., Gemcitabine and irinotecan - A pilot study for patients with unresectable cancer of the bile duct system, Proceedings of the American Society of Clinical Oncology 2003, (2003)
  • [48] Reyes-Vidal J., Gallardo J., Yanez E., Et al., Gemcitabine (G) and cisplatin (C) in the treatment of patients (pts) with unresectable or metastatic gallbladder cancer
  • [49] results of the phase II GOCCHI study 2000-13, Proceedings of the American Society of Clinical Oncology 2003, (2003)
  • [50] Doval D.C., Sekhon J.S., Gupta S.K., Et al., A phase II study of gemcitabine and cisplatin in chemotherapy-naïve, unresectable gall bladder cancer, Br J Cancer, 90, pp. 1516-1520, (2004)
123456