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| IJCEP Copyright © 2007-All rights reserved. |
| International Journal of Clinical and Experimental Pathology |
Int J Clin Exp Pathol 1(1):75-83;2008
Original Article
Prognostic Significance of Race and Tumor Size in Carcinosarcoma of Gallbladder: a
Meta-Analysis of 68 Cases
Lanjing Zhang, Zheng Chen, Mariko Fukuma, Lisa Y. Lee and Maoxin Wu
Department of Pathology, Mount Sinai School of Medicine, New York, NY, 10029 USA.; Eli Lilly and Company, Indianapolis, IN, 46285 USA;
Department of Pathology, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan and Elmhurst Hospital Center, Mount
Sinai Services, Elmhurst, NY, 11373 USA.
Received 7 July 2007; accepted 5 Aug 2007; available online 1 January 2008
Abstract: Carcinosarcoma of gallbladder, also named sarcomatoid carcinoma, and spindle cell carcinoma, is a rare neoplasm. Its
clinical features and prognostic determinants are still poorly understood due to its rarity. We identified 67 qualified cases in published
literatures, and 1 in our institution, consisted of 53 females and 15 males (F:M= 3.25:1). Twenty-seven were Japanese patients and the
rest were mainly from United States and Europe. The mean age was 68.9 years (median 68 year, range 45-91 years). The average tumor
size was 6.6 cm (median 5.2cm, range 1.0-16.0cm, n=48). Adenomcarinoma was the most common epithelial component (61.2%) and
squamous cell carcinoma was the least common (7.5%). Spindle cell type was the most common mesenchymal component (27.3%)
and osteoid was the least common (4.5%). The mean survival was 17.5 months (median 5, range 0 to 85, n=56). The 1-year and 5-year
survival rates were 19±5% and 16±5% (Mean± SD), respectively. Kaplan Meier survival analysis was conducted to examine the prognostic
value of various clinical parameters. We found Japanese patients had longer survival time than non-Japanese ones (mean=19.9 months
vs 11.5 months, median= 6 vs 4 months, n=27 vs 24, P=0.022). Patients with smaller tumor (<5.0 cm) had longer survival time (in
months) than those with larger tumor (Mean 16.9 vs 9.4, median 11 vs 5, n=40, P=0.028). The presence of gallstone, epithelial and
mesenchymal component types, age and sex of the patients were not significant prognostic factors. Together, we identified race
(Japanese vs. non-Janpanese) and tumor size as important prognostic factors, and they might be used for prognosis prediction.
(IJCEP707006).
Key Words: Gallbladder neoplasm, carcinosarcoma, survival outcomes, meta-analysis, Japan,
Full Text PDF , Supplementary table 1.
Address all correspondences to: Maoxin Wu, MD, PhD (Email: maoxin.wu@mssm.edu) and Lisa Y. Lee, MD (Email: LEELI@nychhc.org).
Original Article
Prognostic Significance of Race and Tumor Size in Carcinosarcoma of Gallbladder: a
Meta-Analysis of 68 Cases
Lanjing Zhang, Zheng Chen, Mariko Fukuma, Lisa Y. Lee and Maoxin Wu
Department of Pathology, Mount Sinai School of Medicine, New York, NY, 10029 USA.; Eli Lilly and Company, Indianapolis, IN, 46285 USA;
Department of Pathology, School of Medicine, Keio University, Shinjuku-ku, Tokyo 160-8582, Japan and Elmhurst Hospital Center, Mount
Sinai Services, Elmhurst, NY, 11373 USA.
Received 7 July 2007; accepted 5 Aug 2007; available online 1 January 2008
Abstract: Carcinosarcoma of gallbladder, also named sarcomatoid carcinoma, and spindle cell carcinoma, is a rare neoplasm. Its
clinical features and prognostic determinants are still poorly understood due to its rarity. We identified 67 qualified cases in published
literatures, and 1 in our institution, consisted of 53 females and 15 males (F:M= 3.25:1). Twenty-seven were Japanese patients and the
rest were mainly from United States and Europe. The mean age was 68.9 years (median 68 year, range 45-91 years). The average tumor
size was 6.6 cm (median 5.2cm, range 1.0-16.0cm, n=48). Adenomcarinoma was the most common epithelial component (61.2%) and
squamous cell carcinoma was the least common (7.5%). Spindle cell type was the most common mesenchymal component (27.3%)
and osteoid was the least common (4.5%). The mean survival was 17.5 months (median 5, range 0 to 85, n=56). The 1-year and 5-year
survival rates were 19±5% and 16±5% (Mean± SD), respectively. Kaplan Meier survival analysis was conducted to examine the prognostic
value of various clinical parameters. We found Japanese patients had longer survival time than non-Japanese ones (mean=19.9 months
vs 11.5 months, median= 6 vs 4 months, n=27 vs 24, P=0.022). Patients with smaller tumor (<5.0 cm) had longer survival time (in
months) than those with larger tumor (Mean 16.9 vs 9.4, median 11 vs 5, n=40, P=0.028). The presence of gallstone, epithelial and
mesenchymal component types, age and sex of the patients were not significant prognostic factors. Together, we identified race
(Japanese vs. non-Janpanese) and tumor size as important prognostic factors, and they might be used for prognosis prediction.
(IJCEP707006).
Key Words: Gallbladder neoplasm, carcinosarcoma, survival outcomes, meta-analysis, Japan,
Full Text PDF , Supplementary table 1.
Address all correspondences to: Maoxin Wu, MD, PhD (Email: maoxin.wu@mssm.edu) and Lisa Y. Lee, MD (Email: LEELI@nychhc.org).