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转移性胆囊癌的成功多模式治疗：一例病例报告及文献综述

Successful multimodality treatment of metastatic gallbladder cancer: A case report and review of literature.

作者信息

Zhang Biao, Li Shuang, Liu Zhao-Yi, Peiris Karieshinie Ghandalie Kalandika, Song Li-Fu, Liu Mu-Cang, Luo Peng, Shang Dong, Bi Wei

机构信息

Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China.

出版信息

World J Clin Cases. 2022 Apr 26;10(12):3856-3865. doi: 10.12998/wjcc.v10.i12.3856.

DOI:10.12998/wjcc.v10.i12.3856
PMID:35647145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9100720/
Abstract

BACKGROUND

Gallbladder cancer is the most common malignant tumor in the biliary system, and it is characterized by high aggressiveness and an extremely poor prognosis. Current treatment for advanced gallbladder cancer remains unsatisfactory. Here, we report a patient with advanced gallbladder cancer who was cured by multidisciplinary treatment.

CASE SUMMARY

A 73-year-old male presented to our hospital with right abdominal pain for 3 d and was diagnosed with stage IVB gallbladder cancer with multiple liver metastases, peritoneum metastasis, diaphragm metastasis and lymph node metastases. The patient initially received chemotherapy, targeted therapy, I seed implantation and immunotherapy, as there were no specific indications for radical surgery. During these palliative therapies, the level of tumor markers gradually decreased but remained higher than the normal level, lymph node metastases gradually disappeared, and liver metastasis was gradually limited to the left liver. Finally, the patient received radical surgery with left hepatectomy, radical lymphadenectomy and partial diaphragmatic resection. To date, the patient has survived for more than six years posttreatment, the levels of tumor markers are normal, and imaging examinations show no signs of tumor recurrence.

CONCLUSION

Currently, the prognosis of advanced gallbladder cancer remains unsatisfactory. A single treatment method is not sufficient for patients with advanced gallbladder cancer. Multidisciplinary individualized treatment is essential and should be utilized for advanced gallbladder cancer patients to further improve prognosis.

摘要

背景

胆囊癌是胆道系统最常见的恶性肿瘤，具有高侵袭性和极差的预后。目前晚期胆囊癌的治疗效果仍不尽人意。在此，我们报告一例晚期胆囊癌患者经多学科治疗后治愈的病例。

病例摘要

一名73岁男性因右腹痛3天就诊于我院，被诊断为IVB期胆囊癌，伴有多发肝转移、腹膜转移、膈肌转移及淋巴结转移。由于没有根治性手术的具体指征，患者最初接受了化疗、靶向治疗、碘粒子植入和免疫治疗。在这些姑息治疗期间，肿瘤标志物水平逐渐下降，但仍高于正常水平，淋巴结转移逐渐消失，肝转移逐渐局限于左肝。最后，患者接受了左半肝切除术、根治性淋巴结清扫术和部分膈肌切除术的根治性手术。迄今为止，患者治疗后已存活六年多，肿瘤标志物水平正常，影像学检查未显示肿瘤复发迹象。

结论

目前，晚期胆囊癌的预后仍不尽人意。单一治疗方法对晚期胆囊癌患者并不足够。多学科个体化治疗至关重要，应应用于晚期胆囊癌患者以进一步改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/42a0945e7635/WJCC-10-3856-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/cdd7fb8df513/WJCC-10-3856-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/8ff8e03ecf89/WJCC-10-3856-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/c7e83922568f/WJCC-10-3856-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/8d2f7bb883a8/WJCC-10-3856-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/9cbeb5ff8dd2/WJCC-10-3856-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/2b0f105fc8fa/WJCC-10-3856-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/0c186dcade51/WJCC-10-3856-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/dd94e4836313/WJCC-10-3856-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/42a0945e7635/WJCC-10-3856-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/cdd7fb8df513/WJCC-10-3856-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/8ff8e03ecf89/WJCC-10-3856-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/c7e83922568f/WJCC-10-3856-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/8d2f7bb883a8/WJCC-10-3856-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/9cbeb5ff8dd2/WJCC-10-3856-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/2b0f105fc8fa/WJCC-10-3856-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/0c186dcade51/WJCC-10-3856-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/dd94e4836313/WJCC-10-3856-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15f4/9100720/42a0945e7635/WJCC-10-3856-g009.jpg

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