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Related Experiment Videos

The Landmark Series: Gallbladder Cancer.

Adriana C Gamboa1, Shishir K Maithel2

  • 1Division of Surgical Oncology, Department of Surgery, Emory University, Atlanta, GA, USA.

Annals of Surgical Oncology
|June 1, 2020
PubMed
Summary

Gallbladder carcinoma treatment lacks high-level evidence. Recent trials support adjuvant capecitabine chemotherapy for resected biliary tract cancer and chemoradiotherapy for R1 margins.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Surgical Oncology

Background:

  • Gallbladder carcinoma is rare, leading to limited high-level evidence for treatment.
  • Multimodal treatment strategies are crucial but lack robust clinical trial data.

Purpose of the Study:

  • To review available clinical trials and evidence for gallbladder carcinoma management.
  • To highlight the basis for current consensus statements on multimodal treatment.

Main Methods:

  • Review of four phase III randomized clinical trials (ABC-02, PRODIGE-12/ACCORD-18, BILCAP, BCAT).
  • Inclusion of one phase II single-arm trial (SWOG0809) on adjuvant strategies.
  • Analysis of retrospective data for neoadjuvant therapy and surgical management.

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Main Results:

  • Adjuvant capecitabine chemotherapy is recommended for resected biliary tract cancer.
  • Chemoradiotherapy is a consideration for patients with R1 margins.
  • Consensus on neoadjuvant therapy and surgical management relies on strong retrospective data.

Conclusions:

  • Current evidence supports adjuvant capecitabine and consideration of chemoradiotherapy for gallbladder carcinoma.
  • Further research is needed to establish level I evidence for neoadjuvant and surgical approaches.
  • Multimodal management strategies are guided by the best available evidence, including retrospective data.