Gallbladder Cancer and Peritoneal Metastasis: Is there any role of Cytoreductive Surgery (CRS) and/or Hyperthermic Intraperitoneal Chemotherapy (HIPEC)? A Narrative Review.
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Abstract
Introduction: Gallbladder cancer (GBC) is the most common biliary tract cancer (BTC) worldwide-the majority of GBC patients present with locally advanced or metastatic disease. Peritoneum is one of the most common sites of metastasis in GBC and the most frequent site for recurrence after resection of both non-incidental and incidental GBC (iGBC). Ovarian, colorectal, and gastric cancers also commonly metastasise to the peritoneum, and the role of cytoreductive surgery (CRS) in the form of peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) procedures is well-documented for the treatment of peritoneal metastasis (PM) or peritoneal dissemination or carcinomatosis in these malignancies.
Methods and results: We found ten reports (including five single case reports) of CRS + HIPEC in GBC + PM-both iGBC and non-iGBC. The number of patients ranged from as small as 3-5 to as many as 80. Major morbidity was uncommon; median survival ranged from 7 to 22 months, with 3-year survival around 20-30%. Three reports, including 1, 22, and 35 patients, showed the benefit of prophylactic HIPEC in selected patients with advanced GBC at high risk of developing PM during follow-up.
Conclusion: CRS and/or HIPEC may have a role in the management of PM in GBC.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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