Abstract:

Updates and interpretations of the NCCN Clinical Practice Guidelines 2015 on biliary tract cancers        LIU Lian-xin, LI Ke-yu.Hepatic Surgical Ward of the First Affiliated Hospital of Harbin Medical University, Harbin 150001,China
Corresponding author:LIU Lian-xin,E-mail: liulianxin@medmail.com.cn
Abstract    The updates of NCCN clinical practice guidelines in oncology 2015 V1 on biliary tract cancers include: patients with T1a stage gallbladder cancer that found on pathological review were recommended to consider adjuvant treatment in the basis of observance; gallbladder cancer patients with jaundice were recommended to consider preoperative biliary drainage if operable; adjuvant chemoradiation has been associated with survival benefit in patients with gallbladder cancer, especially in patients with lymph node-positive disease; intra-arterial chemotherapy may be used in a clinical trial in inoperable patients with intrahepatic cholangiocarcinoma while systemic or intra-arterial chemotherapy may be used in a clinical trial in patients with intrahepatic cholangiocarcinoma who found residual local disease after operation; for inoperable patients with extrahepatic cholangiocarcinoma, biliary drainage should be considered for patients with jaundice prior to instituting chemotherapy, furthermore, biopsy was recommended only after determining transplant status. NCCN clinical practice guidelines in oncology offer sufficient information for clinic, but due to the difference of race and region and the heterogeneity of tumor, the new updates would go better through the clinical practice.

Key words: biliary Tract Cancers, National Comprehensive Cancer Network (NCCN)

摘要：

2015年胆道肿瘤V1版美国国立综合癌症网络（NCCN）临床实践指南更新重点包括：术后病理检查发现的T1a期胆囊癌，在观察基础上可考虑辅助治疗；对于出现黄疸的胆囊癌病人，如果可以手术治疗，建议术前行胆道引流；强调胆囊癌术后辅助化放疗对于淋巴结阳性病人生存有益；肝内胆管癌部分强调可将动脉内化疗作为不可手术病人的临床试验，对于术后残余局部病灶病人可将全身系统化疗和动脉内化疗作为临床试验；不可手术的肝外胆管癌病人，如果伴随黄疸应考虑化疗前胆管引流，强调只有在决定了移植可能后才考虑活检。NCCN临床实践指南为临床提供了借鉴，由于种族不同、地域有别以及肿瘤的异质性，更新后的标准需要接受临床实践的检验才能达到进一步完善。

关键词: 胆道癌, 美国国立综合癌症网络