Selvakumar Veda Padma Priya, Zaidi Shuaib, Pande Pankaj, Goel Ashish, Kumar Kapil
Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Sector V, Rohini, Delhi 110085 India.
Department of Surgical Oncology Indraprastha Apollo Hospital, Rohini, Delhi 110085 India.
Indian J Surg Oncol. 2015 Mar;6(1):16-9. doi: 10.1007/s13193-015-0377-0. Epub 2015 Jan 22.
Although rare over most of the world, Gallbladder cancer is very common in northern india. A delayed presentation, aggressive nature,lack of randomised trials and a poor prognosis have all contributed to the nihilistic halo encircling gallbladder cancer. None of the advances in oncology have been exploited enough to shatter the nihilistic halo. In this background we sought to analyze if the addition of neoadjuvant chemotherapy had any impact on the resectability, overall and disease free survival in patients with advanced carcinoma of the gallbladder. We reviewed the records of all patients who underwent surgery for carcinoma of the gall bladder from 2004 to 2010 at our institute retrospectively. Twenty-one patients received neoadjuvant chemotherapy and subsequently taken up for surgery. Outcome analysis of these 21 patients were done by Kaplan meier method and graphs plotted. Out of the 21 patients who were taken up for surgery after neoadjuvant chemotherapy, fourteen patients underwent R0 resection (Group 1). Seven patients had been rendered inoperable on exploration (Group 2). Thus about 66.67 % of patients deemed resectable after neoadjuvant chemotherapy on imaging underwent R0 resection. The mean overall survival of the group 1 was 42.8 months versus 6.6 months of group 2(Hazard Ratio: 3.42). Neoadjuvant chemotherapy improves resectability in some patients with unresectable gall bladder cancer. Resection after neoadjuvant chemotherapy is feasible and may improve survival in a select group of patients. However randomized studies are required to establish its definitive role.
尽管在世界大部分地区胆囊癌都很罕见，但在印度北部却非常常见。就诊延迟、侵袭性强、缺乏随机试验以及预后不良，所有这些都导致了笼罩在胆囊癌周围的虚无主义光环。肿瘤学领域的任何进展都没有得到充分利用来打破这种虚无主义光环。在此背景下，我们试图分析新辅助化疗的加入是否对晚期胆囊癌患者的可切除性、总生存期和无病生存期有任何影响。我们回顾了2004年至2010年在我们研究所接受胆囊癌手术的所有患者的记录。21名患者接受了新辅助化疗，随后接受了手术。采用Kaplan-Meier方法对这21名患者进行了结局分析并绘制了图表。在接受新辅助化疗后接受手术的21名患者中，14名患者进行了R0切除（第1组）。7名患者在探查时被判定无法手术（第2组）。因此，在影像学上被认为在新辅助化疗后可切除的患者中，约66.67%进行了R0切除。第1组的平均总生存期为42.8个月，而第2组为6.6个月（风险比：3.42）。新辅助化疗可提高一些不可切除胆囊癌患者的可切除性。新辅助化疗后进行切除是可行的，并且可能改善一部分患者的生存期。然而，需要进行随机研究来确定其确切作用。
