导管内乳头状粘液性肿瘤（A-IPMN）引起的腺癌前体上皮亚型的临床肿瘤学结果仅限于小规模队列研究。 A-IPMN 亚型之间的复发模式和辅助化疗反应的差异尚不清楚。全球 18 个学术胰腺中心报告了接受 A-IPMN 胰腺切除术（2010-2020 年）患者的临床病理学特征、复发模式和长期结果。使用单变量和多变量分析比较前体上皮亚型组。总共纳入 297 名患者（中位年龄，70 岁；男性，78.9%），其中胃病 54 例（18.2%），胰胆病 111 例（37.3%），胰胆病 80 例（37.3%）。 26.9%）肠道亚型和 52 种（17.5%）混合亚型。胃亚型、胰胆亚型和混合亚型具有相似的临床病理特征，但结果明显不如肠亚型。胃、胰胆、肠和混合亚型的中位复发时间分别为 32、30、61 和 33 个月。与肠亚型相比，胃亚型和胰胆亚型的总体复发率更差（分别为 p = 0.048 和 p = 0.049），但胃亚型和胰胆亚型的结果相当。辅助化疗与胰胆亚型（p = 0.049）的生存率改善相关，但与胃亚型（p = 0.992）、肠亚型（p = 0.852）或混合亚型（p = 0.723）的生存期改善无关。在多变量生存分析中，辅助化疗与胰胆亚型死亡可能性较低相关，尽管具有临界意义[风险比 (HR) 0.56； 95%置信区间（CI）0.31-1.01； p = 0.058]。胃、胰胆和混合亚型的复发和生存结果相当，不如惰性更强的肠道亚型。胰胆亚型可能对辅助化疗有反应，需要进一步研究以确定每种亚型最合适的辅助化疗方案。© 2024。作者。

The clinico-oncological outcomes of precursor epithelial subtypes of adenocarcinoma arising from intraductal papillary mucinous neoplasms (A-IPMN) are limited to small cohort studies. Differences in recurrence patterns and response to adjuvant chemotherapy between A-IPMN subtypes are unknown.Clincopathological features, recurrence patterns and long-term outcomes of patients undergoing pancreatic resection (2010-2020) for A-IPMN were reported from 18 academic pancreatic centres worldwide. Precursor epithelial subtype groups were compared using uni- and multivariate analysis.In total, 297 patients were included (median age, 70 years; male, 78.9%), including 54 (18.2%) gastric, 111 (37.3%) pancreatobiliary, 80 (26.9%) intestinal and 52 (17.5%) mixed subtypes. Gastric, pancreaticobiliary and mixed subtypes had comparable clinicopathological features, yet the outcomes were significantly less favourable than the intestinal subtype. The median time to recurrence in gastric, pancreatobiliary, intestinal and mixed subtypes were 32, 30, 61 and 33 months. Gastric and pancreatobiliary subtypes had worse overall recurrence (p = 0.048 and p = 0.049, respectively) compared with the intestinal subtype but gastric and pancreatobiliary subtypes had comparable outcomes. Adjuvant chemotherapy was associated with improved survival in the pancreatobiliary subtype (p = 0.049) but not gastric (p = 0.992), intestinal (p = 0.852) or mixed subtypes (p = 0.723). In multivariate survival analysis, adjuvant chemotherapy was associated with a lower likelihood of death in pancreatobiliary subtype, albeit with borderline significance [hazard ratio (HR) 0.56; 95% confidence interval (CI) 0.31-1.01; p = 0.058].Gastric, pancreatobiliary and mixed subtypes have comparable recurrence and survival outcomes, which are inferior to the more indolent intestinal subtype. Pancreatobiliary subtype may respond to adjuvant chemotherapy and further research is warranted to determine the most appropriate adjuvant chemotherapy regimens for each subtype.© 2024. The Author(s).