Successful Treatment of Metastatic Gallbladder Carcinoma with PD-L1 Expression by the Combination of PD-1 Inhibitor Plus Bevacizumab with Chemotherapy: A Case Report

Research progress on prognostic factors of gallbladder carcinoma

BACKGROUND

Gallbladder carcinoma is the most common malignant tumor of the biliary system, and has a poor overall prognosis. Poor prognosis in patients with gallbladder carcinoma is associated with the aggressive nature of the tumor, subtle clinical symptoms, ineffective adjuvant treatment, and lack of reliable biomarkers.

PURPOSE

Therefore, evaluating the prognostic factors of patients with gallbladder carcinoma can help improve diagnostic and treatment methods, allowing for tailored therapies that could benefit patient survival.

METHODS

This article systematically reviews the factors affecting the prognosis of gallbladder carcinoma, with the aim of evaluating prognostic risk in patients.

CONCLUSION

A comprehensive and in-depth understanding of prognostic indicators affecting patient survival is helpful for assessing patient survival risk and formulating personalized treatment plans.

Effects of cytoreductive surgery combined with hyperthermic perfusion chemotherapy on prognosis of patients with advanced gallbladder cancer

BACKGROUND

Gallbladder cancer (GC) is a common malignant tumor and one of the leading causes of cancer-related death worldwide. It is typically highly invasive, difficult to detect in the early stages, and has poor treatment outcomes, resulting in high mortality rates. The available treatment options for GC are relatively limited. One emerging treatment modality is hyperthermic intraperitoneal chemotherapy (HIPEC). HIPEC involves delivering heated chemotherapy directly into the abdominal cavity. It combines the strategies of surgical tumor resection and localized chemotherapy administration under hyperthermic conditions, aiming to enhance the concentration and effectiveness of drugs within the local tumor site while minimizing systemic toxicity.

AIM

To determine the effects of cytoreductive surgery (CRS) combined with HIPEC on the short-term prognosis of patients with advanced GC.

METHODS

Data from 80 patients treated at the Punan Branch of Renji Hospital, Shanghai Jiao Tong University School of Medicine between January 2018 and January 2020 were retrospectively analyzed. The control group comprised 44 patients treated with CRS, and the research group comprised 36 patients treated with CRS combined with HIPEC. Then, the survival time and prognostic factors of the two groups were compared, as well as liver and kidney function indices before and six days after surgery. Adverse reactions and complications were recorded in both groups.

RESULTS

The baseline data of the research and control groups were similar (P > 0.05). Six days after surgery, the alanine aminotransferase, aspartate aminotransferase, total bilirubin, and direct bilirubin levels significantly decreased compared to the preoperative levels in both groups (P < 0.05). However, the values did not differ between the two groups six days postoperatively (P > 0.05). Similarly, the postoperative creatinine and blood urea nitrogen levels were significantly lower than the preoperative levels in both groups (P < 0.05), but they did not differ between the groups six days postoperatively (P > 0.05). Furthermore, the research group had fewer postoperative adverse reactions than the control group (P = 0.027). Finally, a multivariate Cox analysis identified the tumor stage, distant metastasis, and the treatment plan as independent factors affecting prognosis (P < 0.05). The three-year survival rate in the study group was higher than that in the control group (P = 0.002).

CONCLUSION

CRS combined with HIPEC lowers the incidence of adverse reactions and improves survival in patients with advanced GC.

Gallbladder adenocarcinoma with upper abdominal pain: A case report

Introduction

The most prevalent malignancy of the biliary system and the fifth most common cancer of the gastrointestinal tract is gallbladder cancer. This cancer is extremely aggressive with a 19 % 5-year survival rate. Herein, we report a case of gallbladder cancer with an ambiguous symptom of upper abdominal pain.

Presentation of case

A 51-year-old woman presented with abdominal pain persisting for 3 months. On examination, a lump on the right abdomen measuring 7 × 5 cm was found. Ultrasound showed a gallbladder mass measuring 8 cm, and magnetic resonance imaging showed an infiltrating gallbladder mass suggestive of segment VI liver malignancy. The patient underwent radical cholecystectomy with en bloc hepatectomy and lymph node dissection. Histopathology revealed poorly differentiated gallbladder adenocarcinoma that metastasized to the liver. The postoperative course was uneventful, and the patient was discharged on postoperative day 5.

Discussion

In our case, we performed radical (extended or margin-clearing) cholecystectomy to remove the gallbladder with a margin of normal liver tissue along with regional lymphadenectomy. This procedure is used to improve staging and decrease the risk of recurrence.

Conclusion

Although gallbladder cancer is rare in Indonesian populations, it has a high mortality rate because of the frequently advanced stage of the disease at the time of diagnosis. Radiography may determine its degree and malignancy features. Regardless of the tumor size, the prognosis of gallbladder cancer depends on its stage and removability.

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Gallbladder cancer is a rare type of malignancy in Indonesian populations.

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The mortality rate is high owing to the frequently advanced stage at diagnosis.

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Radiography may determine the degree and malignancy features of the disease.

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Radical cholecystectomy removes the gallbladder with a margin of normal liver tissue.

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Regional lymphadenectomy improves staging and decreases recurrence.