Successful conversion surgery for locally advanced gallbladder cancer after gemcitabine and nab-paclitaxel chemotherapy.
Successful conversion surgery for locally advanced gallbladder cancer after gemcitabine and nab-paclitaxel chemotherapy.
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DOI：
10.3389/fonc.2022.977963
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发表时间：
2022
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
--
作者：
胆囊癌（GBC）是高度恶性的，通常在晚期才被诊断出来。缺乏手术机会会导致结果不令人满意。该试点研究采用吉西他滨联合白蛋白结合型紫杉醇（AG）作为局部晚期GBC的转化治疗措施，并成功为三名最初不可切除的GBC患者实现了转化手术。我们将介绍我们在改善这种令人沮丧的疾病的结果方面的经验。对每位患者进行放射学和核医学成像，并通过我们的多学科团队（MDT）联合会诊评估可切除性。被评估为不可切除的患者接受 AG 方案治疗，并重新评估治疗反应。当达到完全或部分缓解时，需要 MDT 意见来评估进行 R0 切除的转换手术的可能性。 3 名最初被评估为不可切除的 GBC 患者在采用 AG 方案转换治疗后成功进行了 R0 切除。第一个病例是一位复发性 GBC 患者，评估为局部晚期，最终达到病理完全缓解。第二例为GBC患者，接受R1切除，胆囊床残留病灶，孤立16号淋巴结转移，治疗后病理完全缓解。第三例有多发但可切除的肝转移；达到客观缓解和部分病理缓解。没有患者出现严重的治疗相关不良事件。中位随访 12 个月后，所有病例均未发现复发或转移的证据。转换治疗对那些不可切除的 GBC 患者显示出良好的疗效。吉西他滨联合白蛋白结合型紫杉醇有可能用作晚期 GBC 患者的术前治疗选择。为了进一步探讨AG对GBC患者转化治疗的疗效，一项前瞻性临床试验已注册（ChiCTR2200055698）。
Gallbladder cancer (GBC) is highly malignant and is often diagnosed at the advanced stage. Lack of opportunity to surgery results in an unsatisfactory outcome. This pilot study employed gemcitabine combined with nab-paclitaxel (AG) as a conversion therapeutic measure for locally advanced GBC and successfully achieved conversion surgery in three initially unresectable GBC patients. We will introduce our experience on improving the outcome of this dismal disease. Radiology and nuclear medicine imaging were performed in each patient, and resectability was evaluated by joint consultation of our multi-disciplinary team (MDT). Patients evaluated as unresectable were treated with the AG regimen and re-evaluated for treatment response. When complete or partial response is achieved, MDT opinion would be required to assess the possibility of performing conversion surgery with R0 resection. Three GBC patients who were initially evaluated as unresectable successfully underwent R0 resection after conversion therapy with the AG regimen. The first case was a recurrent GBC patient evaluated as locally advanced and eventually achieved pathological complete response. The second case was a GBC patient who underwent R1 resection with residual lesions in the gallbladder bed and isolated No. 16 lymph node metastasis and who had a pathologically complete response after treatment. The third case had multiple but resectable liver metastases; both objective response and partial pathologic response were achieved. None of the patients experienced serious treatment-related adverse events. All cases revealed no evidence of recurrence or metastasis after a median follow-up of 12 months. Conversion therapy shows a favorable efficacy in those unresectable GBC patients. Gemcitabine plus nab-paclitaxel has the potential to be used as a preoperative treatment option for GBC patients at the advanced stage. To further explore the efficacy of AG on conversion therapy for GBC patients, a prospective clinical trial has been registered (ChiCTR2200055698).
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影响因子：
4.7
作者：
Liu T;Li Q;Zhang W;Zhu Q
通讯作者：
Zhu Q
影响因子：
45.3
作者：
Phelip, Jean marc;Desrame, Jerome;Malka, David
通讯作者：
Malka, David
预测胆囊癌术后复发患者生存率的列线图的开发和验证
影响因子：
4.7
作者：
Chen M;Li S;Topatana W;Lv X;Cao J;Hu J;Lin J;Juengpanich S;Shen J;Cai X
通讯作者：
Cai X
DOI：
10.3760/cma.j.cn112139-20200403-00279
发表时间：
2020-09-01
期刊：
Zhonghua wai ke za zhi [Chinese journal of surgery]
影响因子：
--
作者：
Ren, T;Li, Y S;Liu, Y B
通讯作者：
Liu, Y B
影响因子：
3.7
作者：
Papageorge, Marianna, V;de Geus, Susanna W. L.;Sachs, Teviah E.
通讯作者：
Sachs, Teviah E.