Naveed Shah, Qari Hasina, Thau Cao M, Burasakarn Pipit, Mir Abdul W
Department of Surgical Oncology, Upper GI and HPB Oncosurgery, Sher-E-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Department of Health and Family Welfare, Srinagar, Jammu and Kashmir, India.
Euroasian J Hepatogastroenterol. 2021 Jul-Dec;11(2):87-94. doi: 10.5005/jp-journals-10018-1348.
Recently for advanced gallbladder carcinoma, neoadjuvant chemotherapy has emerged as an important strategy in place of adjuvant chemotherapy with the hope that it will help to improve the resectability and survival.
The goal was to conduct a systematic review of published publications on the benefits of neoadjuvant chemotherapy for advanced gallbladder cancer treatment.
This systematic review followed the Meta-analysis Of Observational Studies in Epidemiology standards. The clinical benefit rate of neoadjuvant chemotherapy, curative resectability rate, and R0 resection were the major outcomes of interest. The secondary outcomes of interest were overall and disease-free survival.
Six published papers were included ( = 420). One-hundred and twenty-eight cases (30.47%) despite receiving neoadjuvant chemotherapy had disease progression. Although 67.38% of patients (283 of 420) in this systematic review showed good response to the neoadjuvant chemotherapy, just 51.66% (217 of 420 cases) were operated, out of which only 171 cases were deemed to be feasible for surgical resection and had curative resection. Out of the cases that underwent curative surgery, 91.81% had R0 resection (157 out of 171 patients). The overall survival rate was found to be 18.5-50.1 months for patients in whom curative surgery was done and 5.0-10.8 months for nonsurgery patients.
No sufficient data exist to advocate the regular use of neoadjuvant chemotherapy in advanced gallbladder carcinoma, as data showed that only 1/3 of patients benefited and had a R0 resection. Further research should be the randomized controlled trials to further quantify the benefit of neoadjuvant chemotherapy in advanced gallbladder carcinoma.
Naveed S, Qari H, Thau CM, . Neoadjuvant Chemotherapy for Advanced Gallbladder Cancer: Do We have Enough Evidence? A Systematic Review. Euroasian J Hepato-Gastroenterol 2021;11(2):87-94.
近年来，对于晚期胆囊癌，新辅助化疗已成为一项重要策略，取代了辅助化疗，以期有助于提高可切除性和生存率。
对已发表的关于新辅助化疗治疗晚期胆囊癌益处的文献进行系统评价。
本系统评价遵循流行病学观察性研究的Meta分析标准。新辅助化疗的临床获益率、根治性切除率和R0切除是主要关注的结果。次要关注结果为总生存期和无病生存期。
纳入6篇已发表论文（n = 420）。128例患者（30.47%）尽管接受了新辅助化疗仍出现疾病进展。虽然本系统评价中67.38%的患者（420例中的283例）对新辅助化疗反应良好，但仅有51.66%（420例中的217例）接受了手术，其中只有171例被认为可行手术切除并进行了根治性切除。在接受根治性手术的病例中，91.81%实现了R0切除（171例患者中的157例）。接受根治性手术患者的总生存期为18.5 - 50.1个月，未手术患者为5.0 - 10.8个月。
没有足够的数据支持在晚期胆囊癌中常规使用新辅助化疗，因为数据显示只有1/3的患者获益并实现了R0切除。进一步的研究应为随机对照试验，以进一步量化新辅助化疗在晚期胆囊癌中的益处。
Naveed S, Qari H, Thau CM, 。晚期胆囊癌的新辅助化疗：我们有足够的证据吗？一项系统评价。《欧亚肝脏胃肠病学杂志》202
