Metastasis to the gallbladder: A single-center experience of 20 cases in South Korea

Table 1 Origin and pathology of the primary malignancies

Site of origin	Pathology
Stomach (n = 8)	Adenocarcinoma (n = 7)
	Signet ring cell carcinoma (n = 1)
Colorectum (n = 3)	Adenocarcinoma (n = 3)
Liver (n = 2)	Hepatocellular carcinoma (n = 2)
Kidney (n = 2)	Renal cell carcinoma (n = 2)
Skin (n = 2)	Melanoma (n = 2)
Extrahepatic bile duct (n = 1)	Adenocarcinoma (n = 1)
Uterine cervix (n = 1)	Squamous cell carcinoma (n = 1)
Appendix (n = 1)	Mucinous adenocarcinoma (n = 1)

Table 2 Concurrent procedures at the time of cholecystectomy

Synchronously diagnosed	Metachronously diagnosed
Anterior resection and liver tumorectomy	Distal pancreatectomy (for pancreatic metastasis)
Low anterior resection and liver tumorectomy	Right hemicolectomy
Total colectomy and liver tumorectomy	Debulking surgery
Palliative common bile duct resection
Palliative gastrojejunostomy
Palliative total gastrectomy
Palliative left lobectomy of the liver
Palliative subtotal gastrectomy and palliative right hemicolectomy

Table 3 Univariate analysis of the factors associated with survival after a diagnosis of MGB

Factor	Median survival1	P value
Sex		0.794
Male (n = 14)	11.2
Female (n = 6)	6.2
Primary origin		0.224
Gastrointestinal organs (n = 15)	8.2
Non-gastrointestinal organs (n = 5)	35.0
Chronological relationship between primary malignancy and MGB		0.913
Synchronous (n = 8)	11.2
Metachronous (n = 12)	6.9
Asymptomatic upon diagnosis of MGB		0.023
Yes (n = 5)	40.0
No (n = 15)	6.9
Presentation with acute cholecystitis		< 0.001
Yes (n = 4)	2.8
No (n = 16)	15.6
Preoperative diagnosis of MGB		0.007
Yes (n = 9)	35.0
No (n = 11)	4.7
Age at diagnosis of the MGB (yr)		0.009
≥ 70 (n = 5)	6.2
< 70 (n = 15)	21.2
Secondary involvement of organs other than the GB		0.586
Yes (n = 11)	15.6
No (n = 9)	8.7
Recurrence at the remaining primary site		0.252
Yes (n = 1)	4.7
No (n = 19)	11.2
R0 resection		< 0.001
Yes (n = 9)	40.0
No (n = 11)	6.2

¹Value in months. Results of log-rank test. MGB: Metastasis to the gallbladder; GB: Gallbladder.

Table 4 Multivariate analysis of the factors associated with survival after a diagnosis of MGB

Factor	HR	95% CI	P value
Male sex	5.78	0.84-39.87	0.075
Asymptomatic upon diagnosis of the MGB	0.79	0.15-4.18	0.781
Presentation with acute cholecystitis	36.12	2.82-463.27	0.006
Preoperative diagnosis of MGB	0.58	0.13-2.62	0.477
Age at diagnosis of the MGB ≥ 70 yr	3.69	0.42-32.38	0.239
R0 resection	0.01	0.001-0.20	0.002

HR: Hazard ratio; CI: Confidence interval.