🦎 蜥蜴花園

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Dec 05, 20232 min read

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🌱來自: snippets

GB

Gallbladder cancer, adenocarcinoma (W/D), LVI-, perineural-, pT2N1(7/9)M0 (AJCC 7th), s/p laparoscopic cholecystectomy

  • LNs (7/9): regional lymph nodes (tumor base) (7/7), peri-CBD lymph node (0/1), group#8a(0/0), group12a(0/0), group12b(0/0), mesentery LN(0/1)
  • Initial presentation:
  • Treatment plan: adjuvant chemotherapy
  • Follow up parameter: abdominal CT scan and tumor marker
  • 2010/00/00: Adjuvant therapy: Patients should be consider adjuvant therapy with complete resected >= T2, node positive, or margin-positive GBC. There is no consensus as to the optimal adjuvant approach. The rate of recurrence is about 50% and above. The purpose of adjuvant CCRT (DFS HR 0.61 for chemotherapy, HR 0.43 for CCRT, recurrence rate 39%, in metaanalysis 2016) is to prolong disease free survival and overall survival and decrease risk of recurrence and distant mets but not 100%. Explain adjuvant chemotherapy regimen of 5FU D1-D5 (425mg/m2) IV, LV (20mg/m2) Q4W for 6 cycles or self-paid gemcitabine 1000mg/m2 IVF 30 min QW for 3 weeks on 1 week off for 6 cycles to reduce risk of mortality by 30%. Post op adjuvant chemotherapy may be started 46 weeks post op. @ Consider start treatment on 00/00, arrange admission for 5FU D1-D5 (425mg/m2) IV, LV (20mg/m2) and check lab. @ Vascular assessment, nutritional assessment before chemotherapy, pharmacist education

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