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Indian Journal of Medical and Paediatric Oncology
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Year : 2005  |  Volume : 26  |  Issue : 4  |  Page : 67-69

Gallbladder cancer : Role of Adjuvant chemotherapy


Institute Rotary Cancer Hospital All India Institute of Medical Sciences New Delhi-110029, India

Correspondence Address:
A Sharma
Institute Rotary Cancer Hospital All India Institute of Medical Sciences New Delhi-110029, India

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Source of Support: None, Conflict of Interest: None


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Gallbladder cancer is the most common biliary tract malignancy. There is a tremendous regional variability in its incidence. Risk factors include genetic susceptibility, gender, presence of gallstones, chronic biliary infections, diet and some anatomical anomalies. Several genetic abnormalities have been described which may be etiologically important as well as carry prognostic significance. These includes mutation in proteins, K-raps and P53 and altered expression of P-glycoprotein, Cox-2 and epidermal growth factor receptor. Most patients present at an advanced stage, overall prognosis is very poor. TNM stage and the extent of surgical resection are the most important prognostic factors. Surgery is the only curative therapy, reserved for the patients with early stage disease. The role of adjuvant therapy, reserved for the patients with early stage disease. The role of adjuvant therapy though employed is not fully defined. The large scale randomized trials are not available. However, data point towards better survival with 5-FU based chemotherapy with or without radiotherapy in node positive cases. The availability of better drugs and combinations may affect the use of chemotherapy in neoadjuvant and adjuvant settings. Novel targeted therapies require exploration alone or in combination with chemotherapy in adjuvant settings. Prospective large scale randomized trials are needed to answer role of adjuvant therapy.


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