Multidisciplinary Therapeutic Approach to Gallbladder Cancer / 대한췌담도학회지

ABSTRACT

Gallbladder cancer is the most common of all the biliary tract cancers. Incidence gradually increases with age, and women are more likely diagnosed with gallbladder cancer. Patients with gallbladder cancer have poor prognosis due to early local and vascular invasion, extensive regional lymph node metastasis, and distant metastasis. Gallbladder cancer is also related with shorter median survival duration and shorter survival duration after recurrence in comparison with hilar cholangiocarcinoma. Complete removal with negative margins is considered as the only curative therapy for patients with gallbladder cancer. The optimal resection comprises cholecystectomy with a limited hepatic resection (segments IVB and V) and portal lymphadenectomy to include the tumor with negative margins. The optimum adjuvant therapy for patients with resected gallbladder cancer has not been confirmed. The greater benefit of radiation therapy was achieved in patients with T2 or greater stage tumors and node-positive disease. Primary options for patients with unresectable or metastatic diseases include 1) clinical trial; 2) fluoropyrimidine-based or gemcitabine-based chemotherapy; or 3) best supportive care including biliary drainage. In patients with advanced stage and jaundice, biliary drainage should be considered before setting up chemotherapy.