胆囊癌转化治疗模式探索与思考

Exploring novel therapeutic approach for advanced gallbladder cancer

胆囊癌病人预后不佳。如何进一步精确评估手术可行性、提高外科根治性手术比例,是改善胆囊癌治疗效果的关键。以病人是否能从外科手术中获益为标准,可将处于局部进展状态而尚未发生远处转移的胆囊癌病人,进一步细分为临界可切除胆囊癌和局部进展期胆囊癌两种类型,并应对局部进展期胆囊癌开展转化治疗。随着综合治疗手段的进步,有望通过系统性治疗联合外科手术的转化治疗模式,提高此类病人的R0切除率,从而改善预后。

Gallbladder cancer has poor prognosis.Accurate assessment of surgical feasibility and improvement of R0 resection rate are the keys to enhancing the surgical outcome of gallbladder cancer at an advanced stage.Based on the criteria of whether patients can benefit from surgery,the authors propose to subdivide those advanced gallbladder cancers without distant metastasis into two types:borderline resectable gallbladder cancer(BRGBC)and locally advanced gallbladder cancer(LAGBC).LAGBC should be classified as unresectable.With the rapid progress in novel therapeutic measures including targeted and immunotherapies,such patients are expected to achieve a high R0 resection rate and a better long-term outcome through systemic therapy combined with surgery.