Real-life experience in the treatment of gallbladder carcinoma by transarterial radioembolization: a multicenter retrospective study

Patients with liver metastases from gallbladder carcinoma have limited treatment options. This retrospective multicenter study evaluated overall survival, tumor control and safety after transarterial radioembolization in this rare patient group. Patients with histologically confirmed gallbladder carcinoma and liver-dominant metastatic disease treated with yttrium-90 or holmium-166 radioembolization at five tertiary centres were retrospectively identified. Baseline clinical and imaging data, details of the radioembolization procedure and follow-up imaging were collected. Tumor response was assessed locally using RECIST 1.1. Overall survival was analysed descriptively using Kaplan–Meier curves. Sixteen patients (9 women, mean age 65.7 ± 5.5 years) were included; 93.8% had received prior systemic chemotherapy and 75.0% had extrahepatic metastases. At approximately 3 months, hepatic disease control was achieved in 81.8% (9/11) of patients with available imaging, whereas global disease control was 36.4% (4/11). Median overall survival was 7.1 months (95% confidence interval 1.7–12.3). The median time to hepatic progression was 115 days and the median time to global progression was 112 days. Procedure-related complications were limited to one coil dislocation, one contrast reaction and one liver abscess. Radioembolization was feasible and well tolerated in patients with liver-dominant metastases from gallbladder carcinoma and provided intrahepatic disease control in a heavily pretreated population. Given the small sample size, these exploratory findings require confirmation in prospective studies. Question: Can transarterial radioembolization (TARE) be a feasible and safe liver-directed treatment approach in carefully selected patients with advanced gallbladder carcinoma and liver-dominant disease? Pertinent findings: In this small retrospective multicenter cohort, median overall survival was 7.1 months, hepatic disease control at 3 months was high among evaluable patients, and short-term safety was favorable; however, global disease control was substantially lower due to frequent extrahepatic progression. Implications for patient care: Radioembolization may be considered in carefully selected patients and in experienced centers as a palliative liver-directed treatment approach when further systemic therapy is not feasible.