Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma of the gallbladder

Abstract

PurposeOur study aims to examine the clinicopathological features, disease progression, management, and outcomes of gallbladder sarcomatoid carcinoma (GBSC) patients.MethodsBetween January 2000 and December 2020, 50 gallbladder cancer (GBC) patients who received surgical treatment and were pathologically verified as GBSC at our institution were enrolled. The clinical and pathological features and survival of these patients were retrospectively reviewed.ResultsThe median overall survival (OS) of GBSC patients was 14.5 months, and the 1-, 2- and 3-year OS rates were 68.0%, 32.0%, and 10.0%, respectively. The median progression-free survival (PFS) was 10.0 months, and the 1-, 2-, and 3-year PFS rates were 42.0%, 16.0%, and 2.0%, respectively. Patients who received radical resection had obviously better OS (18.0 vs. 7.0 months, P<0.001) and PFS (12.0 vs. 5.0 months, P<0.001) than those who underwent palliative resection. Multivariate analysis revealed that vascular invasion (P=0.033), curative operation (P<0.001) and postoperative chemotherapy (P=0.033) were independent risk factors for PFS. We further identified postoperative chemotherapy (P=0.010) and curative operation (P<0.001) as independent prognostic factors affecting the OS of GBSC patients. After curative surgery, patients who underwent S-1-based chemotherapy showed significantly longer recurrence-free survival (RFS) than those who underwent other chemotherapy regimens (20.0 vs 11.0 months, P=0.028).ConclusionGBSC patients always have aggressive biological behaviors and remarkably poor prognoses. Most GBSC patients are diagnosed in advanced stages, and timely radical operation together with postoperative chemotherapy is important. S-1-based chemotherapy may be a selectively efficient regimen to prolong the survival of GBSC patients.

Prognostic factors for resected cases with gallbladder carcinoma: a systematic review and meta-analysis

“…Accumulating evidence have suggested that gallbladder adeno-squamous/squamous carcinoma shared a worse prognosis than those with adenocarcinoma 74 – 79 . Gallbladder mucinous adenocarcinoma 80 and sarcomatoid carcinoma 81 have also been demonstrated to share a worse prognosis than adenocarcinoma. However, there are also pathological subtypes that show a comparable or even more favorable prognosis compared to gallbladder adenocarcinoma.…”

Sarcomatoid carcinoma of the gallbladder: A rare and aggressive form of gallbladder cancer

“…Immunohistochemical study showed positive staining of cytokeratin for the epithelial component (Figure 3A,B) and vimentin for the mesenchymal component (Figure 3C). 1,2 Some tumor cells expressed SMA (Figure 3D). The final histopathological diagnosis was sarcomatoid carcinoma with heterologous differentiation classified as pT3N0M0.…”