| IJCEP Copyright © 2007-All rights reserved. |
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 correspondence 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 correspondence to: Maoxin Wu, MD, PhD (Email: maoxin.wu@mssm.edu) and Lisa Y. Lee, MD (Email: LEELI@nychhc.org).
 | |  | |  | |  | |  | |  |
