Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study

Abstract

Background Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan–Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival. Results Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P > 0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P < 0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases. Conclusions The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

Examination of the characteristics of long-term survivors among patients with gallbladder cancer with liver metastasis who underwent surgical treatment: a retrospective multicenter study (ACRoS1406)

“…It is associated with fewer chemotherapy regimens than other cancers, and surgery is the only curative treatment that can be expected to confer long-term survival in patients with GBC [ 4 ]. In particular, the median survival time of patients with stage IVB GBC and distant metastasis is very poor, at 2–7 months [ 3 , 5 , 6 ]. In clinical practice guidelines, stage IVB GBC is not indicated for resection [ 4 ].…”

Impact of Primary Tumor Resection on Survival of Patients with Metastatic Gallbladder Carcinoma: A Population-Based, Propensity‑Matched Study

“…Although GBC is relatively rare among all types of human malignancies, it is highly aggressive and a great threat to health worldwide. Owing to an insidious onset, rapid progression, asymptomatic development, and high propensity to metastatic dissemination, most patients with GBC are diagnosed with an advanced stage or even distant metastasis at initial diagnosis due to the symptoms of biliary obstruction and pain caused by tumor invasion into surrounding structures [ 3 – 5 ]. At the advanced or metastatic stage, GBC progresses rapidly and spreads frequently to adjacent organs, such as the liver, pancreas, colon, and peritoneum as well as to regional and distant lymph nodes.…”

Risk factors and prognosis of liver metastasis in gallbladder cancer patients: A SEER-based study

“…Previous population-based studies investigated that metastasis of lymph nodes and distant organs is prevalent in GBC, with incidence ranging from 17.9% to 64.5% ( 5 , 6 ). The most frequently observed metastatic organs are the liver, lung, and peritoneum ( 7 ).…”