Combination of portal vein embolization and neoadjuvant chemotherapy for locally advanced gallbladder cancer requiring extended hepatectomy — A novel approach

Singh, Sapna; Goel, Sajal; Aggarwal, Abhishek; Iqbal, Assif; Hazarika, Dibyamohan; Talwar, Vineet

doi:10.1007/s12664-021-01182-8

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Mohapatra et al (2018) In a recent report, better (7/14,50%) respectability rates were attained after adding neoadjuvant chemotherapy (NACT) to PVE. Singh et al (2021) If replicated in larger numbers this could be a valuable addition to management of this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Jaundice in Patients With Gall Bladder Cancer- A Surrogate Marker of Advanced Disease

Sharma,

Behari,

Sharma

et al. 2024

Int. J. Res. Granthaalayah

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Background: Gall bladder cancer (GBC) is most common cancer of biliary tract. R0 resection is the most important predictor of survival. Patients with GBC and jaundice do worse than those without jaundice.Methods: Retrospective analysis of prospectively kept data of patients with GBC admitted to the department of Surgical Gastroenterology at a tertiary care hospital in northern India over10 years from 2011 to 2020. Data on patient demography, clinical profile, imaging characteristics, clinical course, staging, and operative procedures was extracted and analyzed to compare the experience of patients with GBC with jaundice and GBC without jaundice.Results: There were 401 patients with GBC; 75 with jaundice and 326 without jaundice. Patients with GBC and jaundice had a significantly higher incidence of pain abdomen, loss of appetite, loss of weight and presence of an abdominal lump, gastric outlet obstruction and hypoalbuminemia, a shorter duration of symptoms, more number of hospital admissions, a less frequent (4% vs 10.7%) incidental diagnosis of GBC and a higher incidence of GB neck tumors (80% vs 20%). In patients with GBC and jaundice detection of metastatic or locally advanced unresectable disease on imaging (31%), laparoscopy (11%) or laparotomy (31%) precluded resection in majority of patients. Only 2.6% patients with GBC and jaundice could undergo definitive surgery as compared to 71.2% of patients without jaundice.Conclusion: Patients with GBC and jaundice are very likely to have advanced, unresectable disease. Chances of complete resection are slim even after extensive preparation requiring more extensive, time-consuming, costly, multidisciplinary interventions.

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Section: Discussionmentioning

confidence: 99%

Jaundice in Patients With Gall Bladder Cancer- A Surrogate Marker of Advanced Disease

Sharma,

Behari,

Sharma

et al. 2024

Int. J. Res. Granthaalayah

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“…Although all regimens were used in the current study, it is possible that GCS, which has a high response rate, together with the possibility of conversion surgery, should be considered in locally advanced cases. The feasibility of combining PVE and neoadjuvant therapy (GC regimen) has been reported in locally advanced gallbladder cases, with a resectable rate of 50% (7/14) and no 90-day mortality [16]. Regarding safety, previous studies reported that chemotherapy could be continued safely until liver surgery, with no significant difference in hypertrophy response when chemotherapy was continued after PVE in a colorectal liver metastasis series [17,18].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Clinical Course in a Population of Patients with Biliary Tract Cancer Diagnosed as Unresectable After Portal Vein Embolization: A Case Series

IMAMURA,

ADACHI,

MATSUSHIMA

et al. 2023

Kurume Med. J.

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Portal vein embolization (PVE) is recommended as a preoperative procedure for patients with biliary tract cancer scheduled to undergo hepatic resection of more than 50%-60% of the liver. However, details and/or information regarding the follow-up of unresectable cases are often lacking, and the clinical course of unresectable cases is not well analyzed and reported. This study aimed to clarify the clinical prognosis of patients with unresectable biliary tract cancer after PVE. We retrospectively analyzed the clinical backgrounds of patients with biliary tract cancer who underwent PVE without subsequent resection between January 2011 and October 2022. Of the 21 patients with biliary tract cancer who underwent PVE during the study period, eight (38%) cases were unsuitable for resection after PVE for the following reasons: intraoperatively detected dissemination (n=2), para-aortic lymph node metastasis (n=1), liver metastasis (n=1), decreased liver function (n=2), development of liver metastasis while waiting (n=1), and insufficient residual liver volume (n=1). All patients received subsequent chemotherapy, including gemcitabine plus S-1 therapy in three cases, gemcitabine plus cisplatin plus S-1 in three cases, and gemcitabine plus cisplatin or S-1+cisplatin in one case each. As there is currently no curative treatment for biliary tract cancer other than surgery, multidisciplinary management and treatment of patient factors, including tumor factors and liver function, are essential to reducing the number of unresectable cases after PVE.

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“…But Behari et al [ 170 ] could find that only 43% of GBC undergoing extended resection could achieved R0 resection. Singh et al [ 176 ] from Rajiv Gandhi Cancer institute first to explore PVE followed by extended hepatectomy in GBC. In their study on 14 patients following Neo adjuvant chemo therapy (NACT) and portal vein embolization.…”

Section: Studies On Surgical Approach and Resectionmentioning

confidence: 99%

Gallbladder cancer: Progress in the Indian subcontinent

Kumar,

Sarangi,

Gupta

et al. 2024

World J Clin Oncol

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Gallbladder cancer (GBC) is one of the commonest biliary malignancies seen in India, Argentina, and Japan. The disease has dismal outcome as it is detected quite late due to nonspecific symptoms and signs. Early detection is the only way to improve the outcome. There have been several advances in basic as well as clinical research in the hepatobiliary and pancreatic diseases in the West and other developed countries but not enough has been done in GBC. Therefore, it is important and the responsibility of the countries with high burden of GBC to find solutions to the many unanswered questions like etiopathogenesis, early diagnosis, treatment, and prognostication. As India being one of the largest hubs for GBC in the world, it is important to know how the country has progressed on GBC. In this review, we will discuss the outcome of the publications from India highlighting the work and the developments taken place in past several decades both in basic and clinical research.

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Combination of portal vein embolization and neoadjuvant chemotherapy for locally advanced gallbladder cancer requiring extended hepatectomy — A novel approach

Cited by 6 publications

References 32 publications

Jaundice in Patients With Gall Bladder Cancer- A Surrogate Marker of Advanced Disease

Jaundice in Patients With Gall Bladder Cancer- A Surrogate Marker of Advanced Disease

Analysis of the Clinical Course in a Population of Patients with Biliary Tract Cancer Diagnosed as Unresectable After Portal Vein Embolization: A Case Series

Gallbladder cancer: Progress in the Indian subcontinent

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