Comparison of clinicopathological characteristics of mucinous adenocarcinoma and conventional adenocarcinoma of gallbladder

Asian J Surg. 2023 Jan;46(1):283-290. doi: 10.1016/j.asjsur.2022.03.094. Epub 2022 Apr 11.

Abstract

Background: Gallbladder mucinous adenocarcinoma (GBMAC) is a rare type of gallbladder malignant tumor, whereas little is known regarding the clinicopathological features and surgical outcomes of GBMAC.

Methods: From January 2000 till December 2015, 54 GBMAC patients who underwent curative-intent surgical resection at our institution were retrospectively reviewed. We compared the clinicopathological features and surgical outcomes of these GBMAC patients with a relatively large cohort of surgically resected conventional gallbladder adenocarcinoma (GBAC) patients without existence of mucinous components.

Results: The clinicopathological features of GBMAC were significantly different from conventional GBAC, including poorer tumor differentiation (P < 0.001), higher CA19-9 levels (P < 0.001), larger tumor sizes (P = 0.020), advanced AJCC tumor stage (P = 0.002), higher frequency of liver parenchyma invasion (P = 0.020), portal vein invasion (P = 0.003), lymph node metastasis (P = 0.016), lympho-vascular invasion (P < 0.001) and perineural invasion (P = 0.025). Relative to conventional GBAC patients, GBMAC patients showed significantly worse overall survival (OS) (29.0 vs 15.0 months; P < 0.001). Multivariate analysis confirmed the surgical margin (P = 0.046), tumor differentiation grade (P = 0.018), lymph node metastasis (P = 0.024), and presence of signet-ring cell component (P = 0.005) as independent prognostic factors influencing OS of patients with GBMAC.

Conclusion: GBMAC always had more aggressive biological behaviors and poor survival outcomes even after curative surgery. GBMAC patients with the presence of signet-ring cell component showed even worse survival outcome.

Keywords: Curative-intent resection; Gallbladder adenocarcinoma; Gallbladder mucinous adenocarcinoma; Prognosis.

MeSH terms

  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / surgery
  • Adenocarcinoma, Mucinous* / pathology
  • Adenocarcinoma, Mucinous* / surgery
  • Carcinoma, Signet Ring Cell* / pathology
  • Gallbladder Neoplasms* / pathology
  • Gallbladder Neoplasms* / surgery
  • Humans
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies