Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3881-3889
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3881
Gallbladder sarcomatoid carcinoma: Seven case reports
Qing Qin, Ming Liu, Xin Wang
Qing Qin, Ming Liu, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Qing Qin, Department of Oncology, Chengdu Shangjin Nanfu Hospital, Chengdu 611730, Sichuan Province, China
Xin Wang, Department of Abdominal Oncology, Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Qin Q collected the data and contributed to drafting the manuscript; Liu M critically revised the manuscript; Wang X designed the case report presentation. All authors have read and approved the final version to be published.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: There are no conflicts of interest for this study.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin Wang, PhD, Professor, Department of Abdominal Oncology, Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. wangxinhuaxi@126.com
Received: March 25, 2020
Peer-review started: March 25, 2020
First decision: June 8, 2020
Revised: June 21, 2020
Accepted: August 13, 2020
Article in press: August 13, 2020
Published online: September 6, 2020
Processing time: 162 Days and 17.7 Hours
Abstract
BACKGROUND

Gallbladder sarcomatoid carcinoma is a rare and aggressive tumor, and little is known about its clinical behavior, prognosis, and optimal treatment.

CASE SUMMARY

From 1997 to 2017, we collected seven cases of gallbladder sarcomatoid carcinoma at our institution. The median patient age was 68.5 years. Six (85.7%) patients were female. Overall, 85.7% (6/7) of the tumors had a maximal diameter greater than 7 cm. Late TNM stage was associated with a significantly poor prognosis. All patients with advanced-stage (III/IV) disease died from metastases or disease progression shortly after surgery. One patient with stage IIIB disease who received adjuvant chemoradiotherapy (gemcitabine and capecitabine) achieved a progression-free survival (PFS) of 12 mo and overall survival of 15 mo, which might be the longest PFS reported among patients who ultimately experienced recurrence or metastasis.

CONCLUSION

Sarcomatoid carcinoma is a unique and aggressive gallbladder malignancy. Surgery is suggested as the first and only recognized treatment. There is a significant difference in prognosis between patients with early-stage and advanced-stage disease. Postoperative adjuvant therapy may bring survival benefits for locally advanced patients. Gemcitabine combined with fluorouracil and radiotherapy could be a potential strategy.

Keywords: Gallbladder neoplasm; Sarcomatoid carcinoma; Adjuvant therapy; Case report

Core tip: From 1997 to 2017, we collected seven cases of gallbladder sarcomatoid carcinoma at our institution. By reporting these cases, this paper will enrich the clinical information of this rare tumor. TNM stage seemed to be a highly important prognostic indicator. There was a significant difference in prognosis between patients with early-stage and advanced-stage disease. For the first time, we report a patient treated with postoperative adjuvant therapy who achieved a progression-free survival for up to 12 mo. This approach may provide a potential strategy for gallbladder sarcomatoid carcinoma, which is a kind of rare and aggressive tumor with no standard treatment to date.