Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 21, 2009; 15(39): 4877-4882
Published online Oct 21, 2009. doi: 10.3748/wjg.15.4877
Surgical outcome of carcinosarcoma of the gall bladder: A review
Takehiro Okabayashi, Zhao-Li Sun, Robert A Montgomey, Kazuhiro Hanazaki
Takehiro Okabayashi, Kazuhiro Hanazaki, Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi 783-8505, Japan
Takehiro Okabayashi, Zhao-Li Sun, Robert A Montgomery, Department of Surgery, Johns Hopkins University School of Medicine, 720 Rutland Ave., Ross 771, Baltimore, MD 21205, Japan
Author contributions: Okabayashi T and Sun ZL contributed equally to this work; Okabayashi T, Montgomery RA, and Hanazaki K designed research; Okabayashi T and Hanazaki K performed research; Okabayashi T, Sun ZL, Montgomery RA, and Hanazaki K analyzed data; Okabayashi T, Sun ZL, Montgomery RA, and Hanazaki K wrote the paper.
Correspondence to: Dr. Takehiro Okabayashi, Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi 783-8505, Japan. tokabaya@kochi-u.ac.jp
Telephone: +81-88-8802370 Fax: +81-88-8802371
Received: July 23, 2009
Revised: August 26, 2009
Accepted: September 3, 2009
Published online: October 21, 2009
Abstract

Carcinosarcoma, which comprises less than one percent of all gall bladder neoplasms, is characterized by the presence of variable proportions of carcinomatous and sarcomatous elements. Recently, several reports have described patients suffering from carcinosarcoma of the gall bladder. However, there are no large studies regarding the clinicopathologic features, therapeutic management, and surgical outcome of this disease because the number of patients who undergo resection of gall bladder carcinosarcoma at a single institution is limited. A Medline search was performed using the keywords ‘gall bladder’ and ‘carcinosarcoma’. Additional articles were obtained from references within the papers identified by the Medline search. Optimal adjuvant chemotherapy and/or radiotherapy protocols for carcinosarcoma of the gall bladder have not been established. Curative surgical resection offers the only chance for long-term survival from this disease. The outcome of 36 patients who underwent surgical resection for carcinosarcoma of the gall bladder was poor; the 3-year overall survival rate was only 31.0% and the median survival time was 7.0 mo. Since the postoperative prognosis of carcinosarcoma of the gall bladder is worse than that of adenocarcinoma, new adjuvant chemotherapies and/or radiation techniques are essential for improvement of surgical outcome.

Keywords: Gall bladder, Carcinosarcoma, Spindle cell carcinoma, Surgery, Outcome