Daines William P, Rajagopalan Vandana, Grossbard Michael L, Kozuch Peter
Harvard University, Boston, Massachusetts, USA.
Oncology (Williston Park). 2004 Jul;18(8):1049-59; discussion 1060, 1065-6, 1068.
Gallbladder carcinoma and carcinoma of the bile ducts are relatively rare cancers in the United States. These cancers are often diagnosed in an advanced stage due to their nonspecific symptomatology and until recently have been associated with a dismal prognosis. Recent advances in imaging and surgical techniques along with emerging options in palliative chemotherapy have improved the outlook in these cancers. While complete surgical resection remains the only hope of cure in both these cancers, palliative biliary decompression and chemotherapy result in substantial improvement in quality of life. Part 1 of this review, which appeared in last month's issue, provided a relevant and comprehensive update of molecular pathology, imaging modalities, and surgical care. In part 2, we examine palliative care and systemic therapy in gallbladder and biliary tract carcinomas, as well as the use of liver transplantation in the treatment of cholangiocarcinomas. These strategies are of relevance to internists as well as oncologists caring for these patients.
在美国，胆囊癌和胆管癌是相对罕见的癌症。由于这些癌症的症状不具特异性，它们往往在晚期才被诊断出来，并且直到最近，其预后都一直很差。成像和手术技术的最新进展以及姑息化疗的新选择改善了这些癌症的治疗前景。虽然完全手术切除仍然是这两种癌症治愈的唯一希望，但姑息性胆道减压和化疗可显著提高生活质量。本综述的第一部分发表在上个月的期刊上，提供了分子病理学、成像方式和手术治疗的相关全面更新。在第二部分中，我们将探讨胆囊和胆管癌的姑息治疗和全身治疗，以及肝移植在胆管癌治疗中的应用。这些策略对治疗这些患者的内科医生和肿瘤学家都具有重要意义。
