Survival and prognostic factors for postoperative primary appendiceal cancer: a retrospective cohort study based on the Surveillance, Epidemiology, and End Results database

Abstract

Background: The factors affecting the postoperative survival of patients with primary appendiceal cancer (PAC) have yet to be fully explored. And there are no clear guidelines for adjuvant treatment after appendectomy. Whether chemotherapy can prolong patient survival after appendectomy, is critical in guiding postoperative medications. The majority of studies on appendiceal cancer are single case reports, and they focused on the incidence of appendiceal cancer. The present study aimed to investigate the survival characteristics of patients with primary appendiceal cancer after surgery using the Surveillance, Epidemiology, and End Results (SEER) database. Methods:The data of 2,891 cases of primary appendiceal cancer between 2004 to 2015 were obtained from the SEER database and subjected to survival analysis using the Kaplan-Meier method and Cox proportionalhazards model. The annual percentage change (APC) was calculated using the weighted least squares method.Results: The overall age-adjusted incidence rate per 100,000 population steadily increased from 0.58 in 2004 to 1.63 in 2015. For patients who received chemotherapy, the median overall survival (OS) was 65 months and the 5-year OS rate was 51.9%, and for patients who did not receive chemotherapy or whose chemotherapy status was unknown, the median OS was not reached and the 5-year OS rate was 78.9%. Age

Appendiceal adenocarcinoma is associated with better prognosis than cecal adenocarcinoma: a population-based comparative survival study

“…In addition, Hispanic individuals had improved survival compared with non-Hispanics, which has been previously reported in CRC but is a novel finding for appendiceal cancer 3 24. Similar to previous studies, we found SRCC had worse survival than both MAC and NMAC while MAC was associated with lower mortality compared with NMAC 1 10. Not surprisingly, advanced tumour stage and grade exhibited higher mortality rates, while surgical intervention was associated with improved survival.…”

“…Although appendiceal malignancies are rare, their incidence in the USA has steadily increased in the past two decades to 1–2 per million person-years despite stable rates of appendectomies 1–3. Previous large population-based studies have identified key demographic and clinical prognostic factors associated with survival in patients with appendiceal malignancies, including age, race, marital status, histological type, tumour stage, tumour grade, lymph node resection, chemotherapy and surgical intervention 1 4–10. These variables have been used to construct prognostic nomograms that predict overall mortality and disease-specific survival 11 12…”

Current Status of Treatment among Patients with Appendiceal Tumors—Old Challenges and New Solutions?

“…Patients with low-grade tumors had a favorable prognosis. Patients with distant metastases did not experience a prolonged survival benefit from CTH [ 6 ]. Fleischmann et al evaluated the role of regional lymph node (RLN) retrieval on stage migration, OS, and cancer-specific survival (CSS) in appendiceal cancer.…”

“…The incidence of appendix cancer of primary origin (PAC) is estimated to be 1.2–1.63 per 100,000 people in the United States [ 5 , 6 ]. The 5-year overall survival (OS) depends on the histologic type of the PAC.…”

“…The 5-year overall survival (OS) depends on the histologic type of the PAC. According to data from a study by Wang et al, 5-year survival is 90.8%, 92.9%, 84.6%, 63.2%, and 96.6% for colonic-type adenocarcinoma, mucinous adenocarcinoma (MAC), NET, signet ring cell carcinoma (SRCC), and malignant carcinoid, respectively [ 6 ]. Other variables that influence the 5-year OS are age at diagnosis, race of the patients, tumor size, grading, staging, and administration of chemotherapy (CTH).…”