van der Hoeven Joost, Busch Olivier, Bijnen Caroline, Gouma Dirk, van Gulik Thomas
Albert Schweitzer Ziekenhuis, afd. Heelkunde, Dordrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A355.
Over the past decade considerable progress has been made in several fields relating to the diagnosis and treatment of gall bladder cancer. This literature search evaluates if these recent advances have led to improved diagnosis, treatment and survival of patients with gall bladder carcinoma. The increase in the number of cholecystectomies being carried out has resulted in more carcinomas being discovered incidentally, and at an early and treatable stage. The combination of ultrasound and MRI yields the most accurate preoperative staging. Current radiotherapy and chemotherapy in adjuvant and neoadjuvant settings have not shown any survival benefit. Surgical resection remains the only potentially curative option. For in-situ- and T1a-tumours a simple cholecystectomy can be performed resulting in favourable 10-year survival. For T1b- and T2-tumours an additional resection is indicated, resulting in 5-year survival rates of 55-90%. For T3-tumours, only those patients without metastatic disease will benefit from an additional resection.
在过去十年中，与胆囊癌诊断和治疗相关的几个领域取得了相当大的进展。这项文献检索评估了这些最新进展是否已使胆囊癌患者的诊断、治疗和生存率得到改善。胆囊切除术数量的增加导致更多的癌症被偶然发现，且处于早期可治疗阶段。超声和磁共振成像（MRI）相结合可产生最准确的术前分期。目前在辅助和新辅助治疗中使用的放疗和化疗尚未显示出任何生存获益。手术切除仍然是唯一可能治愈的选择。对于原位癌和T1a期肿瘤，可进行单纯胆囊切除术，10年生存率良好。对于T1b期和T2期肿瘤，需要进行额外切除，5年生存率为55%至90%。对于T3期肿瘤，只有那些没有转移疾病的患者将从额外切除中获益。
