Back to 2025 Posters
CLINICOPATHOLOGICAL FEATURES AND SURVIVAL OUTCOMES OF PURE GALLBLADDER SQUAMOUS CELL CARCINOMA: A CHINA EXPERIENCE
Yu-Shi Dai
*, Rui-Qi Zou, Fei Liu, FuYu Li
Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Background
Gallbladder cancer (GBC) is the most common malignancy of the biliary system and the sixth most frequent gastrointestinal cancer. It is aggressive, often asymptomatic in early stages, and has a poor prognosis, with a 5-year survival rate under 5%, despite radical resection being the only curative option. Adenocarcinoma (AC) accounts for 80–95% of cases, while squamous cell carcinoma (SCC) is rare, comprising 1–3%. Recent studies suggest SCC has a poorer prognosis than AC. This study retrospectively analyzes SCC cases over the past decade to investigate its clinicopathological features and survival outcomes.
Methods
We reviewed patients diagnosed with SCC at West China Medical Center, Sichuan University, from 2010 to 2020. Inclusion criteria were confirmed pathological SCC and radical resection. Excluded were patients with mixed histology, palliative surgery, or external re-resections. Ethical approval was obtained.
Demographic, clinical, and pathological data were retrospectively collected. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier analysis and Cox regression were used to assess survival factors, with significance set at P < 0.05.
Results
A total of 26 SCC patients (53.8% female, median age 61 years) were analyzed. Common symptoms included abdominal discomfort (73.1%) and jaundice (38.5%). Most tumors were advanced (88.4% stage III/IV), with a median size of 7 cm. Liver invasion occurred in 76.9%, and lymph node metastasis in 38.5%. Only 23.1% received adjuvant chemotherapy.
Median OS was 13.9 months, with a 1-year OS rate of 46.5%. Negative lymph node status and smaller tumor size were linked to longer survival. Age over 60, advanced stage, larger tumors, elevated carcinoembryonic antigen (CEA), and absence of adjuvant therapy were independent predictors of poor OS and RFS.
Discussion
SCC presents with aggressive behavior, rapid progression, advanced tumor stages, and high invasion rates. Its pathogenesis may involve squamous metaplasia or a chronic irritation-induced metaplasia-dysplasia-carcinoma sequence. Compared to AC, SCC is associated with larger tumors and higher lymph node metastasis rates. Preoperative CEA elevation was a reliable prognostic marker. Radical resection is essential, though its efficacy is limited by SCC's biology. The role of adjuvant therapy remains uncertain, indicating the need for standardized protocols and further SCC-specific research.
Conclusion
SCC of the gallbladder is a rare and aggressive subtype with poor prognosis, even after radical resection. Early diagnosis, tailored treatment strategies, and further research are necessary to improve outcomes.
The pathological characteristics of pure gallbladder squamous cell carcinoma patients. A) hematoxylin-eosin staining; B) CK56; C) p40; D) p63; E) PCK; F) surgical specimen images of tumor
Kaplan-Meier Survival Analysis of pure gallbladder squamous cell carcinoma patients. A) Overall survival (OS); B) Recurrence free survival (RFS); C) Relationship between lymph node status and OS; D) Relationship between lymph node status and RFS; E) Relationship between tumor stage and OS; F) Relationship between tumor size and OS; G) Relationship between age and OS; H) Relationship between age and RFS; I) Relationship CEA age and OS; J) Relationship CEA age and RFS
Back to 2025 Posters
