Surgical Management of Locally Advanced and Metastatic Gallbladder Cancer

Area of Science:

• Gastrointestinal Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Gallbladder cancer has a poor prognosis due to its aggressive nature.
• Systemic therapy has evolved from single-agent chemotherapy to multi-agent regimens.
• Advancements enable surgical resection of previously unresectable tumors.

Purpose of the Study:

• To review current treatment practices for locally invasive and metastatic gallbladder cancer.
• To discuss emerging treatment options for gallbladder cancer.
• To highlight the role of systemic therapy as a bridge to surgical resection.

Main Methods:

• Review of current literature on systemic and surgical treatments for gallbladder cancer.
• Analysis of treatment advancements, including chemotherapy, immunotherapy, and targeted therapy.
• Examination of surgical techniques for advanced gallbladder cancer, including extended resections and vascular reconstruction.

Main Results:

• Systemic therapy, including immune checkpoint inhibitors, has improved outcomes for gallbladder cancer.
• Surgical options for locally advanced tumors have expanded, enabling resection with negative margins.
• Evidence suggests potential benefit from resection in Stage IV gallbladder cancer patients.

Conclusions:

• Modern systemic therapies offer a bridge to surgical resection for advanced gallbladder cancer.
• Surgical interventions are becoming more aggressive and complex for resectable advanced disease.
• Emerging treatments hold promise for improving survival in gallbladder cancer patients.