Division of Surgical Oncology, Department of Surgery, Emory University, Atlanta, GA, USA.
Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Ann Surg Oncol. 2020 Aug;27(8):2846-2858. doi: 10.1245/s10434-020-08654-9. Epub 2020 May 30.
Given the rarity of gallbladder carcinoma, level I evidence to guide the multimodal treatment of this disease is lacking. Since 2010, four randomized phase III clinical trials including ABC-02, PRODIGE-12/ACCORD-18, BILCAP, and BCAT, and a single-arm phase II trial (SWOG0809) have been reported on the use of adjuvant strategies for biliary malignancies. These trials have led to the recommendation that patients with resected biliary tract cancer should be offered adjuvant capecitabine chemotherapy and those with R1 margins could be considered for chemoradiotherapy. Because there is no level I evidence to guide neoadjuvant therapy or surgical management, current consensus is based on strong retrospective data. The following review summarizes available trials and highlights the best available evidence that form the basis of consensus statements for the multimodal management of gallbladder carcinoma.
鉴于胆囊癌的罕见性，缺乏指导这种疾病多模式治疗的一级证据。自 2010 年以来，已经报告了四项包括 ABC-02、PRODIGE-12/ACCORD-18、BILCAP 和 BCAT 的随机 III 期临床试验，以及一项单臂 II 期试验（SWOG0809），这些试验涉及胆道恶性肿瘤的辅助治疗策略。这些试验导致了这样的建议，即应该为接受切除的胆道癌患者提供辅助卡培他滨化疗，对于 R1 切缘的患者，可以考虑化疗和放疗。由于没有指导新辅助治疗或手术管理的一级证据，目前的共识是基于强有力的回顾性数据。以下综述总结了可用的试验，并强调了形成胆囊癌多模式管理共识声明基础的最佳现有证据。
