Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts 02114, USA.
Oncologist. 2010;15(2):168-81. doi: 10.1634/theoncologist.2009-0302. Epub 2010 Feb 10.
Gallbladder cancer (GBC) represents the most common and aggressive type among the biliary tree cancers (BTCs). Complete surgical resection offers the only chance for cure; however, only 10% of patients with GBC present with early-stage disease and are considered surgical candidates. Among those patients who do undergo "curative" resection, recurrence rates are high. There are no established adjuvant treatments in this setting. Patients with unresectable or metastatic GBC have a poor prognosis. There has been a paucity of randomized phase III data in this field. A recent report demonstrated longer overall survival with gemcitabine in combination with cisplatin than with gemcitabine alone in patients with advanced or metastatic BTCs. Molecularly targeted agents are under development. In this review, we attempt to discuss the current status and key issues involved in the management of GBC.
胆囊癌 (GBC) 是胆道系统癌症 (BTCs) 中最常见且侵袭性最强的类型。彻底的手术切除是唯一的治愈机会;然而,只有 10%的 GBC 患者在早期出现并被认为是手术候选者。在那些接受“治愈性”切除的患者中,复发率很高。在这种情况下,尚无既定的辅助治疗方法。不可切除或转移性 GBC 患者预后较差。在这一领域,缺乏随机 III 期数据。最近的一份报告表明,与单独使用吉西他滨相比,在晚期或转移性 BTCs 患者中,吉西他滨联合顺铂可延长总体生存期。分子靶向药物正在开发中。在这篇综述中,我们试图讨论 GBC 管理中涉及的当前状况和关键问题。