PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2015; 36(02): 79-84
DOI: 10.4103/0971-5851.158829
POSITION PAPER

Indian Council of Medical Research consensus document for the management of gall bladder cancer

Hari Shankar Shukla
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
,
Bhawna Sirohi
Mazumdar Shaw Cancer Centre, Narayana Health, Bengaluru, Karnataka, India
,
Anu Behari
Department of GI Surgery, SGPGI, Lucknow, Uttar Pradesh, India
,
Atul Sharma
Department of Medical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi, India
,
Jahar Majumdar
Department of Surgical Oncology, Chittaranjan National Cancer Institute, Kolkata, West Bengal, India
,
Manomoy Ganguly
Department of Surgery, Army Hospital, Rohtak, Haryana, India
,
Mallika Tewari
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
,
Sandeep Kumar
All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
,
Sunil Saini
HIMS, Jolly Grant, Dehradun, Uttarakhand, India
,
Peush Sahni
Department of GI Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Tomcha Singh
Department of Radiotherapy, RIMS, Imphal, Manipur, India
,
Vinay Kumar Kapoor
Department of GI Surgery, SGPGI, Lucknow, Uttar Pradesh, India
,
V Sucharita
Indian Council of Medical Research, New Delhi, India
,
Tanvir Kaur
Indian Council of Medical Research, New Delhi, India
,
Deepak Kumar Shukla
Indian Council of Medical Research, New Delhi, India
,
Goura Kishor Rath
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

Abstract

The document is based on consensus among the experts and best available evidence pertaining to Indian population and is meant for practice in India.All postcholecystectomy gallbladder specimens should be opened and examined carefully by the operating surgeon and be sent for histopathological examination.All "incidental" gall bladder cancers (GBCs) picked up on histopathological examination should have an expert opinion.Evaluation of a patient with early GBC should include essential tests: A computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal and liver function tests. magnetic resonance imaging/positron emission tomography (PET)-CT are not recommended for all patients.For early stage disease (up to Stage IVA), surgery is recommended. The need for adjuvant treatment would be guided by the histopathological analysis of the resected specimen.Patients with Stage IVB/metastatic disease must be assessed for palliative e.g. endoscopic or radiological intervention, chemotherapy versus best supportive care on an individual basis. These patients do not require extensive workup outside of a clinical trial setting.There is an urgent need for multicenter trials from India covering various aspects of epidemiology (viz., identification of population at high-risk, organized follow-up), clinical management (viz., bile spill during surgery, excision of all port sites, adjuvant/neoadjuvant therapy) and basic research (viz., what causes GBC).

Keywords

Gall bladder cancer - ICMR - guidelines - treatmemt


Publikationsverlauf

Artikel online veröffentlicht:
12. Juli 2021

© 2015. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas of cancer in India. Int J Cancer 2005;116:740-54.
  • 2 National Cancer Registry Programme, Indian Council of Medical Research: Three Year Report of Population Based Cancer Registries; 2009-2011. ICMR, Three Year Report of the PBCRs: 2006-2008; 2008. Available from: http://www.pbcrindia.org/. [Last accessed on 2015 May 6].
  • 3 Eckel F, Brunner T, Jelic S, ESMO Guidelines Working Group. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2011;22 Suppl 6:vi40-4.
  • 4 NCCN Clinical Practice Guidelines in Oncology. Hepatobiliary Cancers. Version 2; 2014. Available from: http://www.nccn.org. [Last accessed 2015 May 8].
  • 5 Regimbeau JM, Fuks D, Bachellier P, Le Treut YP, Pruvot FR, Navarro F, et al. Prognostic value of jaundice in patients with gallbladder cancer by the AFC-GBC-2009 study group. Eur J Surg Oncol 2011;37:505-12.
  • 6 Bartlett DL, Fong Y. Tumours of the gall bladder. In: Blumgart LH, Fong Y, editors: Surgery of the Liver and Biliary Tract. 3 rd ed. London: WB Saunders; 2000. p. 993-1015.
  • 7 Ohtani T, Shirai Y, Tsukada K, Hatakeyama K, Muto T. Carcinoma of the gallbladder: CT evaluation of lymphatic spread. Radiology 1993;189:875-80.
  • 8 Efremidis SC, Vougiouklis N, Zafiriadou E, Sofianou F, Sbarounis C, Fardellas Y, et al. Pathways of lymph node involvement in upper abdominal malignancies: Evaluation with high-resolution CT. Eur Radiol 1999;9:868-74.
  • 9 Kim JH, Kim TK, Eun HW, Kim BS, Lee MG, Kim PN, et al. Preoperative evaluation of gallbladder carcinoma: Efficacy of combined use of MR imaging, MR cholangiography, and contrast-enhanced dual-phase three-dimensional MR angiography. J Magn Reson Imaging 2002;16:676-84.
  • 10 Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH. The role of staging laparoscopy in primary gall bladder cancer - An analysis of 409 patients: A prospective study to evaluate the role of staging laparoscopy in the management of gallbladder cancer. Ann Surg 2013;258:318-23.
  • 11 Shukla PJ, Barreto SG, Arya S, Shrikhande SV, Hawaldar R, Purandare N, et al. Does PET-CT scan have a role prior to radical re-resection for incidental gallbladder cancer? HPB (Oxford) 2008;10:439-45.
  • 12 Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC Cancer Staging Manual. 7 th ed. New York, NY: Springer; 2010.
  • 13 de Aretxabala XA, Roa IS, Burgos LA, Araya JC, Villaseca MA, Silva JA. Curative resection in potentially resectable tumours of the gallbladder. Eur J Surg 1997;163:419-26.
  • 14 Miyazaki M, Itoh H, Ambiru S, Shimizu H, Togawa A, Gohchi E, et al. Radical surgery for advanced gallbladder carcinoma. Br J Surg 1996;83:478-81.
  • 15 Behari A, Sikora SS, Wagholikar GD, Kumar A, Saxena R, Kapoor VK. Longterm survival after extended resections in patients with gallbladder cancer. J Am Coll Surg 2003;196:82-8.
  • 16 Toyonaga T, Chijiiwa K, Nakano K, Noshiro H, Yamaguchi K, Sada M, et al. Completion radical surgery after cholecystectomy for accidentally undiagnosed gallbladder carcinoma. World J Surg 2003;27:266-71.
  • 17 Pawlik TM, Gleisner AL, Vigano L, Kooby DA, Bauer TW, Frilling A, et al. Incidence of finding residual disease for incidental gallbladder carcinoma: Implications for re-resection. J Gastrointest Surg 2007;11:1478-86.
  • 18 Fong Y, Jarnagin W, Blumgart LH. Gallbladder cancer: Comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg 2000;232:557-69.
  • 19 Ito H, Ito K, D′Angelica M, Gonen M, Klimstra D, Allen P, et al. Accurate staging for gallbladder cancer: Implications for surgical therapy and pathological assessment. Ann Surg 2011;254:320-5.
  • 20 Wagholikar GD, Behari A, Krishnani N, Kumar A, Sikora SS, Saxena R, et al. Early gallbladder cancer. J Am Coll Surg 2002;194:137-41.
  • 21 Wakai T, Shirai Y, Yokoyama N, Ajioka Y, Watanabe H, Hatakeyama K. Depth of subserosal invasion predicts long-term survival after resection in patients with T2 gallbladder carcinoma. Ann Surg Oncol 2003;10:447-54.
  • 22 Barreto SG, Pawar S, Shah S, Talole S, Goel M, Shrikhande SV. Patterns of failure and determinants of outcomes following radical re-resection for incidental gallbladder cancer. World J Surg 2014;38:484-9.
  • 23 Fuks D, Regimbeau JM, Pessaux P, Bachellier P, Raventos A, Mantion G, et al. Is port-site resection necessary in the surgical management of gallbladder cancer? J Visc Surg 2013;150:277-84.
  • 24 Lundberg O, Kristoffersson A. Port site metastases from gallbladder cancer after laparoscopic cholecystectomy. Results of a Swedish survey and review of published reports. Eur J Surg 1999;165:215-22.
  • 25 Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 2000;87:418-22.
  • 26 Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, et al. Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: Analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci 2013;20:518-24.
  • 27 Negi SS, Singh A, Chaudhary A. Lymph nodal involvement as prognostic factor in gallbladder cancer: Location, count or ratio? J Gastrointest Surg 2011;15:1017-25.
  • 28 Kaneoka Y, Yamaguchi A, Isogai M, Harada T, Suzuki M. Hepatoduodenal ligament invasion by gallbladder carcinoma: Histologic patterns and surgical recommendation. World J Surg 2003;27:260-5.
  • 29 Shimizu Y, Ohtsuka M, Ito H, Kimura F, Shimizu H, Togawa A, et al. Should the extrahepatic bile duct be resected for locally advanced gallbladder cancer? Surgery 2004;136:1012-7.
  • 30 Agarwal AK, Mandal S, Singh S, Sakhuja P, Puri S. Gallbladder cancer with duodenal infiltration: Is it still resectable? J Gastrointest Surg 2007;11:1722-7.
  • 31 Duffy A, Capanu M, Abou-Alfa GK, Huitzil D, Jarnagin W, Fong Y, et al. Gallbladder cancer (GBC): 10-year experience at Memorial Sloan-Kettering Cancer Centre (MSKCC). J Surg Oncol 2008;98:485-9.
  • 32 Kayahara M, Nagakawa T. Recent trends of gallbladder cancer in Japan: An analysis of 4,770 patients. Cancer 2007;110:572-80.
  • 33 Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, et al. Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer 2002;95:1685-95.
  • 34 Mojica P, Smith D, Ellenhorn J. Adjuvant radiation therapy is associated with improved survival for gallbladder carcinoma with regional metastatic disease. J Surg Oncol 2007;96:8-13.
  • 35 Wang SJ, Fuller CD, Kim JS, Sittig DF, Thomas CR Jr, Ravdin PM. Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer. J Clin Oncol 2008;26:2112-7.
  • 36 Agrawal S, Gupta PK, Rastogi N, Lawrence A, Kumari N, Das KJ, et al. Outcomes of adjuvant chemoradiation and predictors of survival after extended cholecystectomy in gall bladder carcinoma: A single institution experience from an endemic region. J Gastrointest Cancer 2015;46:48-53.
  • 37 Sirohi B, Mitra A, Jagannath P, Singh A, Ramadvar M, Kulkarni S, et al. Neoadjuvant chemotherapy in patients with locally advanced gallbladder cancer. Future Oncol 2015;11:1501-9.
  • 38 Sirohi B, Singh A, Jagannath P, Shrikhande SV. Chemotherapy and targeted therapy for gall bladder cancer. Indian J Surg Oncol 2014;5:134-41.
  • 39 Sharma A, Mohanti B, Raina V, Shukla N, Pal S, Dwary A, et al. A phase II study of gemcitabine and oxaliplatin (Oxigem) in unresectable gall bladder cancer. Cancer Chemother Pharmacol 2010;65:497-502.
  • 40 Doval DC, Sekhon JS, Gupta SK, Fuloria J, Shukla VK, Gupta S, et al. A phase II study of gemcitabine and cisplatin in chemotherapy-naive, unresectable gall bladder cancer. Br J Cancer 2004;90:1516-20.
  • 41 Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, et al. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: A randomized controlled study. J Clin Oncol 2010;28:4581-6.
  • 42 Eckel F, Schmid RM. Chemotherapy in advanced biliary tract carcinoma: A pooled analysis of clinical trials. Br J Cancer 2007;96:896-902.
  • 43 Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 2010;362:1273-81.
  • 44 Sirohi B, Rastogi S, Singh A, Sheth V, Dawood S, Talole S, et al. Use of gemcitabine-platinum in Indian patients with advanced gall bladder cancer. Future Oncol 2015;11:1191-200.
  • 45 Malka D, Cervera P, Foulon S, Trarbach T, de la Fouchardière C, Boucher E, et al. Gemcitabine and oxaliplatin with or without cetuximab in advanced biliary-tract cancer (BINGO): A randomised, open-label, non-comparative phase 2 trial. Lancet Oncol 2014;15:819-28.