담낭암에 대한 다학제 치료 = Multidisciplinary Therapeutic Approach to Gallbladder Cancer

국문 초록 (Abstract)

담낭암은 예후가 나쁜 암종이지만 초기에 수술 치료는 매우 효과적이며 진행된 병기라도 방사선 또는 항암 방사선 병합요법이 예후를 향상시키는데 도움이 될 수 있으므로 외과, 영상의학과, 방사선 종양학과, 병리학과, 내과 의사 간의 다학제 치료가 중요하다.

다국어 초록 (Multilingual 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 nodepositive 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.
Korean J Pancreas Biliary Tract 2018;23(1):20-23

참고문헌 (Reference)

1 Butte JM, "The role of laparoscopic staging in patients with incidental gallbladder cancer" 13 : 463-472, 2011

2 Lee SE, "Systematic review on the surgical treatment for T1 gallbladder cancer" 17 : 174-180, 2011

3 Ben-Josef E, "SWOG S0809: a phase II intergroup trial of adjuvant capecitabine and gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma" 33 : 2617-2622, 2015

4 Agarwal AK, "Role of staging laparoscopy in primary gallbladder cancer--an analysis of 409 patients: a prospective study to evaluate the role of staging laparoscopy in the management of gallbladder cancer" 258 : 318-323, 2013

5 Wang SJ, "Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer" 26 : 2112-2117, 2008

6 Jamagin WR, "Patterns of initial disease recurrence after resection of gallbladder carcinoma and hilar cholangiocarcinoma: implications for adjuvant therapeutic strategies" 98 : 1689-1700, 2003

7 Wang SJ, "Nomogram for predicting the benefit of adjuvant chemoradiotherapy for resected gallbladder cancer" 29 : 4627-4632, 2011

8 Valle JW, "New horizons for precision medicine in biliary tract cancers" 7 : 943-962, 2017

9 Ministry of Health & Welfare, "Korea Central Cancer Registry" Ministry of Health & Welfare

10 Hawkins WG, "Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer" 11 : 310-315, 2004

11 Fuks D, "Incidental gallbladder cancer by the AFC-GBC-2009 Study Group" 35 : 1887-1897, 2011

12 Shih SP, "Gallbladder cancer: the role of laparoscopy and radical resection" 245 : 893-901, 2007

13 Bertran E, "Gallbladder cancer: incidence and survival in a high-risk area of Chile" 127 : 2446-2454, 2010

14 Fong Y, "Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention" 232 : 557-569, 2000

15 Valle J, "Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer" 362 : 1273-1281, 2010

16 D'Angelica M, "Analysis of the extent of resection for adenocarcinoma of the gallbladder" 16 : 806-816, 2009