Subtypes of invasive intracholecystic papillary-tubular neoplasms: a propensity score-matched Surveillance, Epidemiology, and End Results analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The clinicopathologic and prognostic heterogeneity of invasive intracholecystic papillary-tubular neoplasm (ICPN) remains poorly characterized. Epidemiologic trends and survival differences between its major subtypes require further elucidation. This study aimed to compare the incidence trends, mortality, and survival outcomes between gallbladder papillary adenocarcinoma (GPA) and gallbladder mucinous adenocarcinoma (GMA).Methods: This population-based cohort study included 604 patients with invasive ICPN [2000–2022] from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence and mortality trends were analyzed using Joinpoint regression. Propensity score matching (PSM; 1:1) was used to balance baseline characteristics. Survival was compared by Kaplan-Meier and log-rank tests. Prognostic factors were identified using multivariable Cox regression.Results: Incidence and incidence-based mortality (IBM) of ICPN decreased significantly [annual percentage change (APC) =−5.5%, P<0.001; APC =−2.9%, P<0.05]. After PSM (n=342), GPA was associated with longer overall survival (OS) (41.0 vs. 22.0 months) and cancer-specific survival (CSS) (113.0 vs. 30.0 months) (both P=0.002). GMA was an independent risk factor for poor OS [hazard ratio (HR) =1.554] and CSS (HR =1.725) (both P<0.001), along with high tumor grade, advanced T stage, nodal and distant metastasis. Subgroup analysis showed that chemotherapy was associated with improved OS and CSS in GMA (HR =0.409; HR =0.366, both P<0.001) but not in GPA, suggesting a subtype-specific association. T-stage stratification confirmed that chemotherapy benefited only T3/T4 GMA patients (both P<0.001).Conclusions: Incidence and mortality of invasive ICPN have declined over the past 22 years. GPA carries a significantly better prognosis than GMA. Adjuvant chemotherapy may be associated with improved survival specifically for T3/T4 stage GMA, suggesting that subtype- and stage-tailored management warrants further investigation in prospective studies.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7224099768