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| 1 | Multimodality management of gallbladder cancer can lead to a better outcome:Experience from a tertiary care oncology centre in North India显示文摘BACKGROUND Surgical resection is a treatment of choice for gallbladder cancer(GBC)patients but only 10%of patients have a resectable disease at presentation.Even after surgical resection,overall survival(OS)has been poor due to high rates of recurrence.Combination of surgery and systemic therapy can improve outcomes in this aggressive disease.AIM To summarize our single-center experience with multimodality management of resectable GBC patients.METHODS Data of all patients undergoing surgery for suspected GBC from January 2012 to December 2018 was retrieved from a prospectively maintained electronic database.Information extracted included demographics,operative and perioperative details,histopathology,neoadjuvant/adjuvant therapy,follow-up,and recurrence.To know the factors associated with recurrence and OS,univariate and multivariate analysis was done using log rank test and cox proportional hazard analysis for categorical and continuous variables,respectively.Multivariate analysis was done using multiple regression analysis.RESULTS Of 274 patients with GBC taken up for surgical resection,172(62.7%)were female and the median age was 56 years.On exploration,102 patients were found to have a metastatic or unresectable disease(distant metastasis in 66 and locally unresectable in 34).Of 172 patients who finally underwent surgery,93(54%)underwent wedge resection followed by anatomical segment IVb/V resection in 66(38.4%)and modified extended right hepatectomy in 12(7%)patients.The postoperative mortality at 90 d was 4.6%.During a median follow-up period of 20 mo,71(41.2%)patients developed recurrence.Estimated 1-,3-,and 5-years OS rates were 86.5%,56%,and 43.5%,respectively.Estimated 1-and 3-year disease free survival(DFS)rates were 75%and 49.2%,respectively.On multivariate analysis,inferior OS was seen with pT3/T4 tumor(P=0.0001),perineural invasion(P=0.0096),and R+resection(P=0.0125).However,only pT3/T4 tumors were associated with a poor DFS(P<0.0001).CONCLUSION Multimodality treatment significantly improves the 5-year survival rate of patients with GBC up to 43%.R+resection,higher T stage,and perineural invasion adversely affect the outcome and should be considered for systemic therapy in addition to surgery to optimize the outcomes.Multimodality treatment of GBC has potential to improve the survival of GBC patients. | Shaifali Goel Abhishek Aggarwal Assif Iqbal Vineet Talwar Swarupa Mitra Shivendra Singh | 2021 | World Journal of Gastroenterology2021，27，45： | 5 |
| 2 | Effect of post design on resisitance to fracture of endodontically treated teeth with complete crown显示文摘 | Assif D Bitenski A Pilo R | 1993 | Joumal of Prosthetic Dentistry1993，69，： | 1 |
| 3 | A possible role for CXCR4 and its ligand, the CXC chemokine stromal cell-derived factor-1,in the development of bone narrow metastases in neuroblastoma显示文摘 | Geminder H Sagi Assif O Goldberg L | 2001 | J Immuol2001，167，8： | 1 |
| 4 | Effect of post design on resistance to fracture of endodontically treated teeth with complete crowns 显示文摘 | Assif D Bitenski A Pilo R | 1993 | J Prosthet Dent1993，69，1： | 1 |
| 5 | Biomechanical considerations in restoring endodontically treated teeth 显示文摘 | Assif D Gorfil C | 1994 | J Prosthet Dent1994，71，6： | 1 |
| 6 | Effect of post design on resistance to fracture of endodontically treated teeth with complete crowns显示文摘 | Assif D Bitenski A Pilo R | 1993 | J Prosthet Dent1993，69，： | 1 |
| 7 | The cantilever fixed partial denture-a literature review显示文摘 | Himmel R Pilo R Assif D | 1992 | J Prosthet Dent1992，67，4： | 1 |
| 8 | Effect of post design on resistance to fracture of endodontically treated teeth with complete crowns显示文摘 | ASSIF D BITENSKI A PILO R | 1993 | J Prosthet Dent1993，69，1： | 1 |
| 9 | Photoelastic analysis of stress transfer by endodontically treated teeth to the supporting structure using different restorative techniques显示文摘 | Assif D Oren E Marshak B L | 1989 | The Journal of prosthetic dentistry1989，61，5： | 1 |
| 10 | Restoring teeth following crown lengthening procedures显示文摘 | Assif D Pilo R'Marshak B | 1991 | Pmsthct Dent1991，65，1： | 1 |
| 11 | Biomechanical considerations in restoring endodontically treated teeth显示文摘 | Assif D Gorfil C | 1994 | J Prosthet Dent1994，71，6： | 1 |
| 12 | Photoelastic analysis of stress transfer by endodontically treated teeth to the supporting structure using different restorative techniques显示文摘 | Assif D Oren E Marshak BL | 1989 | J Prosthet Dent1989，61，5： | 1 |
| 13 | Ground sen- sorimotor interaction histories in an information theoretic metric space for robot ontogeny显示文摘 | Naeem Assif Mirza Chrystopher L Nehaniv | 2007 | International Society of Adaptive Behavior2007，7，7： | 1 |
| 14 | Effect of post design on re- sistance to fracture of endodontically treated teeth with corn pletecrowns 显示文摘 | Assif D Bitenski A Pilo R | 1993 | J Prosthet Dent1993，69，1： | 1 |
| 15 | Biomechanical considerations in restoring endodontically treated显示文摘 | Assif D Gorfil C | 1994 | J ProsthetDe nt1994，71，6： | 1 |
| 16 | Effect of post design on resistance to fracture of endodontically treated teeth with complete crowns显示文摘 | Assif D Bitenski A Pilo R | 1993 | J Prosthet Dent1993，69，1： | 1 |
| 17 | Photoelastic analysis of stress transfer by endodontically treated teeth to the surpporting structure using different restorative techniques显示文摘 | Assif D Oren E Marshak B L | 1989 | J Prosthet Dent1989，61，5： | 1 |
| 18 | Effect of post design onresistance to fracture of endodontically treated teeth withcomplete crowns显示文摘 | Assif D Bitenski A Pilo R | 1993 | J Prosthet Dent1993，69，1： | 1 |
| 19 | Retention of serrated endodontic posts with a composite luting agent: Effect of cement thickness 显示文摘 | Assif D Bleicher S | 1986 | J Prosthet Dent1986，56，6： | 1 |
| 20 | Photoelastic analysis of stress transfer by endodontically treated teeth to the supporting structure using different restorative techniques显示文摘 | Assif D Oren E Marshak BL | 1989 | J Prosthet Dent1989，61，5： | 1 |
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