Clinicopathological features and survival outcomes of rare histologic variants of gallbladder cancer.
adenocarcinoma of gallbladder
adenosquamous carcinoma of gallbladder
gallbladder cancer
papillary carcinoma of gallbladder
rare gallbladder cancers
squamous cell carcinoma of gallbladder
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
26
06
2019
accepted:
15
11
2019
pubmed:
30
11
2019
medline:
30
11
2019
entrez:
30
11
2019
Statut:
ppublish
Résumé
Adenocarcinoma (AC) is the most common histological type in gallbladder carcinoma (GBC). Squamous cell carcinoma (SCC), adenosquamous carcinoma (ASC), and papillary carcinoma (PC) are rare histologic variants of GBC. Patients with AC, SCC, ASC, and PC of the gallbladder between 2004 and 2013 were identified from the National Cancer Database. Univariate and multivariate analyses were performed, and Kaplan-Meier curves were used to compare overall survival (OS) based on histological subtype. A total of 5956 patients ≥18 years of age were included in the final analysis. Most patients (n = 5398; 90.6%) had AC compared with variant histologies. PC (n = 227; 3.8%) was the most common variant, followed by ASC (n = 216; 3.6%) and SCC (n = 115; 1.9%); 70.3% were female and 78.9% Caucasian. The median age was 70 (range, 25-90) years. Surgical resection was performed in 77.7% of AC, 53.0% of SCC, 88.9% of ASC, and 96.9% of PC (P < .001). Systemic therapy after surgery was administered in 25.1% of AC, 18.3% of SCC, 35.7% of ASC, and 19.4% of PC (P = .001). In multivariate analysis, multiagent chemotherapy was associated with improved OS in all histologies except for SCC and PC (p < .001), and adjuvant systemic therapy was associated with improved OS in ASC and AC (P < .001). Survival differs between the gallbladder variants. Except for SCC, GBC variants underwent surgical resection more often than AC. Adjuvant systemic therapy was associated with improved OS in ASC and AC.
Sections du résumé
BACKGROUND
BACKGROUND
Adenocarcinoma (AC) is the most common histological type in gallbladder carcinoma (GBC). Squamous cell carcinoma (SCC), adenosquamous carcinoma (ASC), and papillary carcinoma (PC) are rare histologic variants of GBC.
METHODS
METHODS
Patients with AC, SCC, ASC, and PC of the gallbladder between 2004 and 2013 were identified from the National Cancer Database. Univariate and multivariate analyses were performed, and Kaplan-Meier curves were used to compare overall survival (OS) based on histological subtype.
RESULTS
RESULTS
A total of 5956 patients ≥18 years of age were included in the final analysis. Most patients (n = 5398; 90.6%) had AC compared with variant histologies. PC (n = 227; 3.8%) was the most common variant, followed by ASC (n = 216; 3.6%) and SCC (n = 115; 1.9%); 70.3% were female and 78.9% Caucasian. The median age was 70 (range, 25-90) years. Surgical resection was performed in 77.7% of AC, 53.0% of SCC, 88.9% of ASC, and 96.9% of PC (P < .001). Systemic therapy after surgery was administered in 25.1% of AC, 18.3% of SCC, 35.7% of ASC, and 19.4% of PC (P = .001). In multivariate analysis, multiagent chemotherapy was associated with improved OS in all histologies except for SCC and PC (p < .001), and adjuvant systemic therapy was associated with improved OS in ASC and AC (P < .001).
CONCLUSION
CONCLUSIONS
Survival differs between the gallbladder variants. Except for SCC, GBC variants underwent surgical resection more often than AC. Adjuvant systemic therapy was associated with improved OS in ASC and AC.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
294-302Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Wistuba II, Gazdar AF. Gallbladder cancer: lessons from a rare tumour. Nat Rev Cancer. 2004;4(9):695-706.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34.
Nemunaitis JM, Brown-Glabeman U, Soares H, et al. Gallbladder cancer: review of a rare orphan gastrointestinal cancer with a focus on populations of New Mexico. BMC Cancer. 2018;18(1):665.
Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118(7):1591-1602.
Sharma A, Sharma KL, Gupta A, Yadav A, Kumar A. Gallbladder cancer epidemiology, pathogenesis and molecular genetics: Recent update. World J Gastroenterol. 2017;23(22):3978-3998.
Donohue JH, Stewart AK, Menck HR. The National Cancer Data Base report on carcinoma of the gallbladder, 1989-1995. Cancer. 1998;83(12):2618-2628.
Aloia TA, Járufe N, Javle M, et al. Gallbladder cancer: expert consensus statement. HPB. 2015;17(8):681-690.
Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates. Cancer. 1992;70(6):1493-1497.
Chan KM, Yu MC, Lee WC, Jan YY, Chen MF. Adenosquamous/squamous cell carcinoma of the gallbladder. J Surg Oncol. 2007;95(2):129-134.
Kim WS, Jang KT, Choi DW, et al. Clinicopathologic analysis of adenosquamous/squamous cell carcinoma of the gallbladder. J Surg Oncol. 2011;103(3):239-242.
Wan X, Zhang H, Chen C, et al. Clinicopathological features of gallbladder papillary adenocarcinoma. Medicine. 2014;93(27):e131.
Kalayarasan R, Javed A, Sakhuja P, Agarwal AK. Squamous variant of gallbladder cancer: is it different from adenocarcinoma? Am J Surg. 2013;206(3):380-385.
Roa JC, Tapia O, Cakir A, et al. Squamous cell and adenosquamous carcinomas of the gallbladder: clinicopathological analysis of 34 cases identified in 606 carcinomas. Mod Pathol. 2011;24(8):1069-1078.
Gulwani HV, Gupta S, Kaur S. Squamous cell and adenosquamous carcinoma of gall bladder: a clinicopathological study of 8 cases isolated in 94 cancers. Indian J Surg Oncol. 2017;8(4):560-566.
Oohashi Y, Shirai Y, Wakai T, Nagakura S, Watanabe H, Hatakeyama K. Adenosquamous carcinoma of the gallbladder warrants resection only if curative resection is feasible. Cancer. 2002;94(11):3000-3005.
Bilimoria KY, Stewart DP, Winchester CY, Ko AK. The National Cancer Data Base: a powerful initiative to improve cancer care in the United States. Ann Surg Oncol. 2008;15:683-690.
Liu Y, Nickleach DC, Zhang C, Switchenko JM, Kowalski J. Carry out streamlined routine data analyses with reports for observational studies: introduction to a series of generic SAS® macros. F1000Res. 2018;7:1955.
Nishihara K, Nagai E, Izumi Y, Yamaguchi K, Tsuneyoshi M. Adenosquamous carcinoma of the gallbladder: a clinicopathological, immunohistochemical and flow-cytometric study of twenty cases. Jpn J Cancer Res. 1994;85(4):389-399.
Samuel S, Mukherjee S, Ammannagari N, et al. Clinicopathological characteristics and outcomes of rare histologic subtypes of gallbladder cancer over two decades: a population-based study. PLoS One. 2018;13(6):e0198809.
Benson AB, D'Angelica MI, Abbott DE, et al. NCCN guidelines insights: hepatobiliary cancers, version 1.2017. J Natl Compr Canc Netw. 2017;15(5):563-573.
Mantripragada KC, Hamid F, Shafqat H, Olszewski AJ. Adjuvant therapy for resected gallbladder cancer: analysis of the National Cancer Data Base. J Natl Cancer Inst. 2017;109(2):djw202.
Ma N, Cheng H, Qin B, Zhong R, Wang B. Adjuvant therapy in the treatment of gallbladder cancer: a meta-analysis. BMC Cancer. 2015;15:615.
Primrose JN, Fox R, Palmer DH, et al. Adjuvant capecitabine for biliary tract cancer: the BILCAP randomized study. J Clin Oncol. 2017;35(15_suppl):4006-4006.
Zaidi MY, Maithel SK. Updates on gallbladder cancer management. Curr Oncol Rep. 2018;20(2):21.
Wang J, Narang AK, Sugar EA, et al. Evaluation of adjuvant radiation therapy for resected gallbladder carcinoma: a multi-institutional experience. Ann Surg Oncol. 2015;22(suppl 3):1100-1106.
Song HW, Chen C, Shen HX, et al. Squamous/adenosquamous carcinoma of the gallbladder: analysis of 34 cases and comparison of clinicopathologic features and surgical outcomes with adenocarcinoma. J Surg Oncol. 2015;112(6):677-680.
Albores-Saavedra J, Tuck M, McLaren BK, Carrick KS, Henson DE. Papillary carcinomas of the gallbladder: analysis of noninvasive and invasive types. Arch Pathol Lab Med. 2005;129(7):905-909.
Lee DY, Teng A, Pedersen RC, et al. Racial and socioeconomic treatment disparities in adolescents and young adults with stage II-III rectal cancer. Ann Surg Oncol. 2017;24(2):311-318.