Clinical features and prognosis of primary gallbladder sarcomatoid carcinoma: a single institutional experience from China

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Abstract Purpose: Our study aims to examine the clinicopathological features, disease progression, management, and outcomes of gallbladder sarcomatoid carcinoma (GBSC) patients.Methods: Between January 2000 and December 2020, 50 GBC patients received surgical treatment and pathologically verified as GBSC at our institution were enrolled. The clinical and pathological features and survival of these patients were retrospectively reviewed.Results: The 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%, 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) compared with those 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 OS of GBSC patients. In patients after curative operation, those underwent S-1 based chemotherapy showed significant longer recurrence free survival (RFS) compared to those with other chemotherapy plans (20.0 vs 11.0 months, P=0.028).Conclusion: GBSC patients always have aggressive biological behaviors and remarkably poor prognoses. Most GBSC patients are diagnosed in advanced stages, timely radical operation together with postoperative chemotherapy are significant important. S-1 based chemotherapy may be a selectively efficient plan to prolong the survival of GBSC patients.

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