Zou Rui-Qi, Hu Hai-Jie, Lv Tian-Run, Liu Fei, Ma Wen-Jie, Wang Jun-Ke, Dai Yu-Shi, Yang Si-Qi, Hu Ya-Fei, Li Fu-Yu
Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Front Oncol. 2022 Sep 27;12:1009673. doi: 10.3389/fonc.2022.1009673. eCollection 2022.
Our study aims to examine the clinicopathological features, disease progression, management, and outcomes of gallbladder sarcomatoid carcinoma (GBSC) patients.
Between 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.
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%, 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 . 7.0 months, P<0.001) and PFS (12.0 . 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 11.0 months, P=0.028).
GBSC 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.
本研究旨在探讨胆囊肉瘤样癌（GBSC）患者的临床病理特征、疾病进展、治疗及预后情况。
选取2000年1月至2020年12月期间在我院接受手术治疗且病理确诊为GBSC的50例胆囊癌（GBC）患者。回顾性分析这些患者的临床和病理特征及生存情况。
GBSC患者的中位总生存期（OS）为14.5个月，1年、2年和3年OS率分别为68.0%、32.0%和10.0%。中位无进展生存期（PFS）为10.0个月，1年、2年和3年PFS率分别为42.0%、16.0%和2.0%。接受根治性切除术的患者OS（18.0比7.0个月，P<0.001）和PFS（12.0比5.0个月，P<0.001）明显优于接受姑息性切除术的患者。多因素分析显示，血管侵犯（P=0.033）、根治性手术（P<0.001）和术后化疗（P=0.033）是PFS的独立危险因素。我们进一步确定术后化疗（P=0.010）和根治性手术（P<0.001）是影响GBSC患者OS的独立预后因素。根治性手术后，接受基于S-1化疗的患者无复发生存期（RFS）明显长于接受其他化疗方案的患者（20.0比11.0个月，P=0.028）。
GBSC患者通常具有侵袭性生物学行为且预后极差。大多数GBSC患者在晚期被诊断，及时进行根治性手术并联合术后化疗很重要。基于S-1的化疗可能是延长GBSC患者生存期的一种选择性有效方案。
