Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 11;13(6):e0198809.
doi: 10.1371/journal.pone.0198809. eCollection 2018.

Clinicopathological characteristics and outcomes of rare histologic subtypes of gallbladder cancer over two decades: A population-based study

Sandeep Samuel  1 , Sarbajit Mukherjee  2 , Nischala Ammannagari  3 , Venkata K Pokuri  3 , Boris Kuvshinoff  4 , Adrienne Groman  5 , Charles M LeVea  6 , Renuka Iyer  3
Affiliations

Clinicopathological characteristics and outcomes of rare histologic subtypes of gallbladder cancer over two decades: A population-based study

Sandeep Samuel et al. PLoS One. .

Abstract

Background: There is limited literature about the clinicopathological characteristics and outcomes of rare histologic variants of gallbladder cancer (GBC).

Methods: Using SEER database, surgically managed GBC patients with microscopically confirmed adenocarcinoma, adenosquamous/squamous cell carcinoma and papillary carcinoma were identified from 1988 to 2009. Patients with second primary cancer and distant metastasis at presentation were excluded. The effect of clinicopathological variables on overall survival (OS) and disease specific survival (DSS) were analyzed using univariate and multivariate proportional hazards modeling. All associations were considered statistically significant at an alpha error of 0.01.

Results: Out of 4738 cases, 217 adenosquamous/squamous (4.6%), 367 papillary (7.7%), and 4154 adenocarcinomas (87.7%) were identified. Median age was 72 years. Higher tumor grade (grade 2, 3, 4 versus grade 1), higher T stage (T2, T3, T4 versus T1), lymph node positivity (N1 versus N0) and adenosquamous/squamous histology (versus adenocarcinoma) had worse OS and DSS (p < .001). Papillary GBC had better OS and DSS than adenocarcinoma (HR = 0.7; p < .001). Radical surgery (versus simple cholecystectomy) had better OS (HR = 0.83, p = 0.002) in multivariate analysis. OS rates at 3 and 5 years were 0.56 and 0.44 for papillary, 0.3 and 0.22 for adenocarcinoma, and 0.14 and 0.12 for adenosquamous/squamous histology, while DSS rates at 3 and 5 years were 0.67 and 0.61 for papillary, 0.38 and 0.31 for adenocarcinoma, and 0.17 and 0.16 for adenosquamous/squamous subtypes respectively.

Conclusion: Papillary GBC had better survival outcomes while adenosquamous/squamous GBC had worse survival outcomes compared to gallbladder adenocarcinoma.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier curves for overall survival (A) and disease specific survival (B) based on the three histologic types of gallbladder carcinoma.
Fig 2
Fig 2. Kaplan-Meier overall survival curves among the three histologic types of gallbladder carcinoma based on the American Joint Committee on cancer staging groups [31].
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA: a cancer journal for clinicians. 2016; 66(1):7–30. - PubMed
    1. Benson AB 3rd, D’Angelica MI, Abbott DE, Abrams TA, Alberts SR, Saenz DA et al. NCCN Guidelines Insights: Hepatobiliary Cancers, Version 1.2017. J Natl Compr Canc Netw. 2017. May; 15(5):563–573. - PMC - PubMed
    1. Ausania F, Tsirlis T, White SA, French JJ, Jaques BC, Charnley RM et al. Incidental pT2-T3 gallbladder cancer after a cholecystectomy: outcome of staging at 3 months prior to a radical resection. HPB (Oxford). 2013. August;15(8):633–7. - PMC - PubMed
    1. Belli G, Cioffi L, D’Agostino A, Limongelli P, Belli A, Russo G et al. Revision surgery for incidentally detected early gallbladder cancer in laparoscopic era. J Laparoendosc Adv Surg Tech A. 2011. Jul-Aug;21(6):531–4. doi: 10.1089/lap.2011.0078 - DOI - PubMed
    1. 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. - PubMed

Publication types