Staging, Treatment, and Future Approaches of Gallbladder Carcinoma

Shukla, Sanjeev K.; Singh, Govind; Shahi, K. S.; Bhuvan,; Pant, Prabhat

doi:10.1007/s12029-017-0036-5

Cited by 43 publications

(40 citation statements)

References 41 publications

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“…Gallbladder cancer has a dismal prognosis overall, with over one‐third of patients presenting with distant metastasis at time of diagnosis. By contrast, patients who present with early‐stage disease have a more favourable outcome.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

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Section: Introductionmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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“…GBC is the most aggressive malignancy of biliary tract. Due to the silent and rapid expansion of tumor, most patients are diagnosed at advanced stage, resulting in limited effectiveness of chemotherapy, and a low impact on overall survival (Ferlay et al, 2015;Hundal and Shaffer, 2014;Sharma et al, 2017;Shukla et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…This lethal malignancy with a median survival expectancy of less than 1 year, ranks the 5th global incidence as a cancer of gastrointestinal tract. Its annual incidence (2.2/100,000) and mortality (1.7/100,000) vary with ethnicity and geographical localization (Hundal and Shaffer, 2014;Sharma et al, 2017;Shukla et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Correlation of adenosine deaminase operating under nitro-oxidative stress with tumor and vascularization in patients with advanced gallbladder carcinoma

Tounsi¹,

Djerdjouri²,

Bouzid³

et al. 2019

J Appl Biomed

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This study investigates serum redox status and adenosine catabolism markers in relation to tumor and angiogenesis, in patients with gallbladder carcinoma (GBC).The level of adenosine deaminase (ADA) and xanthine oxidase (XO) activities, nitrites (NO 2 -), glutathione (GSH) and malondialdehyde (MDA) were measured in sera of 40 GBC patients and 40 healthy donors. In parallel, 15 tumors at TNM stage IV were scored for CD34 expression and microvessel density (MVD).The results showed that XO and ADA activities, nitrites and MDA levels enhanced by 1.26 (p < 0.01), 2.69, 2.0, and 3.2-fold (p < 0.001), respectively, while those of GSH decreased by 44.6% (p < 0.001). According to receiver operating characteristic (ROC) curve, the optimal cut-off for XO, ADA, MDA, GSH and nitrites were 5.41U/l, 17.02 U/l, 3.72 μM, 36.91 μM and 21.21 μM, respectively. Spearman correlation revealed that ADA activity correlated to nitrites levels (r = 0.3419, p < 0.05) and XO activity (r = 0.5487, p < 0.001). Multivariate binary logistic regression analysis revealed that MDA (OR = 5.78, p < 0.05), ADA (OR = 1.28, p < 0.001) and XO (OR = 2.81, p < 0.05) correlated positively to GBC. CD34 was up expressed in 73.3% of tumors at intermediate to high levels. Multiple regression analysis showed that ADA affected MVD (r = 0.604, p < 0.01).The results suggest that high MDA/GSH ratio is a potential biomarker of GBC. In addition, the oxidative adenosine catabolism indicated that active purine salvage pathway could support tumor progression by sustaining angiogenesis. Highlights:• Adenosine deaminase (ADA), xanthine oxidase (XO) and nitrites increased in GBC; • ADA and XO activities correlated with GBC; • ADA activity supported microvessel density (MVD) in advanced GBC; • High serum MDA/GSH ratio as potential risk factor in GBC.

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“…32 However, as is well known, GBC is not sensitive to the current chemotherapeutic drugs. 33,34 Chemotherapy resistance is mainly related to the adaptation of cancer cells to the multiple stresses induced by drugs, which is attributed to a variety of mechanisms, such as drug efflux, drug metabolism, inactivation of apoptosis, angiogenesis, induction of autophagy, etc. 35,36 Meanwhile, autophagy is constitutively activated in chemotherapy.…”

Section: The Cytotoxic Effect Of Ptt Could Be Enhanced By Chemotherapmentioning

confidence: 99%

<p>Gallbladder Cancer Progression Is Reversed by Nanomaterial-Induced Photothermal Therapy in Combination with Chemotherapy and Autophagy Inhibition</p>

Cai¹,

Wang²,

Wang³

et al. 2020

IJN

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Introduction: Gallbladder cancer (GBC) is the most common malignancy in biliary tract with extremely poor prognosis. Photothermal therapy (PTT) shows great promises for tumor therapy, which causes tumor cell death via selectively directed heating released by nanoparticles under the near-infrared irradiation. Through degrading damaged organelles and misfolded proteins in autophagosomes, autophagy plays a vital role in maintaining the intracellular homeostasis. The present study attempted to combine chemotherapy and autophagy blocking with PTT. Materials and Methods: We purchased multi-walled carbon nanotubes from Nanostructured and Amorphous Materials and performed PTT using an 808-nm diode laser. The cytotoxic effects of PTT and chemotherapy in vitro were assessed by cell viability analysis. The effects of PTT and chemotherapy on autophagy in vitro were assessed by GFP-LC3 and Western blot. And these results were confirmed by in vivo experiment. Results: Both PTT and chemotherapy could trigger cytoprotective autophagy to tolerate the cellular stresses and prolong the survival of GBC cell; therefore, the blocking of autophagy could enhance the efficacy of PTT and chemotherapy in GBC treatment in vitro and in vivo. Conclusion: Chemotherapeutic drug doxorubicin and autophagy inhibitor chloroquine could enhance the efficacy of nanoparticle-mediated hyperthermia in GBC.

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Staging, Treatment, and Future Approaches of Gallbladder Carcinoma

Cited by 43 publications

References 41 publications

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Correlation of adenosine deaminase operating under nitro-oxidative stress with tumor and vascularization in patients with advanced gallbladder carcinoma

<p>Gallbladder Cancer Progression Is Reversed by Nanomaterial-Induced Photothermal Therapy in Combination with Chemotherapy and Autophagy Inhibition</p>

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