title: Clinicopathological features of gallbladder papillary adenocarcinoma.
abstract: Although patients with gallbladder papillary adenocarcinoma (GBPA) appear to have better prognoses than patients with other pathological subtypes of gallbladder carcinoma (GBC), the clinicopathological features and outcomes of GBPA have not been fully explored. This study therefore analyzed the clinicopathological characteristics and outcomes of GBPA.This study included 16 patients with GBPA and 101 with gallbladder adenocarcinoma (GBA) not otherwise specified (NOS), all diagnosed pathologically after surgical resection. Clinicopathological and survival data were retrospectively collected and compared. Fever was significantly more common in GBPA (7/16 vs 10/101; P = 0.000). Serum carbohydrate antigen 19-9 level was increased in 1 of 9 patients with GBPA and 39 of 76 with GBA (P = 0.022). More patients with GBPA underwent curative resection (15/16 vs 54/101; P = 0.009). Pathologically, patients with GBPA were at much earlier tumor (T) (4 in situ, 8 T1; P = 0.000) and Tumor, Node, Metastases (TNM) stages (P = 0.000). The overall 1-, 3-, and 5-year survival rates were significantly higher in patients with GBPA (100%, 76.9%, and 76.9%, respectively), than in patients with GBA (72.2%, 38.8%, and 31.0%, respectively; P = 0.001). Preoperative jaundice (odds ratio 7.69; 95% confidence interval, 1.53-38.76; P = 0.013) was a significant prognostic factor in patients with GBA, but was no longer significant when the patients with GBA and GBPA were pooled together. The clinicopathological features of patients with GBPA differed from those in patients with GBA (not otherwise specified). Pooling of patients may mask prognostic factors in each group.
authors.affiliation: From the Department of Liver Surgery (XW, HZ, XY, AW, CZ, LF, LH, HY, HZ, XS); Department of pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (CC); and Liver Center and The Transplant Institute, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (RM).
authors.forename: Xueshuai
authors.initials: X
authors.lastname: Wan
authors.forename: Haohai
authors.initials: H
authors.lastname: Zhang
authors.forename: Cuimin
authors.initials: C
authors.lastname: Chen
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Yang
authors.forename: Anqiang
authors.initials: A
authors.lastname: Wang
authors.forename: Chengpei
authors.initials: C
authors.lastname: Zhu
authors.forename: Lilan
authors.initials: L
authors.lastname: Fu
authors.forename: Ruoyu
authors.initials: R
authors.lastname: Miao
authors.forename: Lian
authors.initials: L
authors.lastname: He
authors.forename: Huayu
authors.initials: H
authors.lastname: Yang
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhao
authors.forename: Xinting
authors.initials: X
authors.lastname: Sang
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D005704:Gallbladder / Q000473:pathology*; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged