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Clinical characteristics and prognostic factors for primary appendiceal carcinoma
Author(s) -
KO Yoon Ho,
PARK Se Hoon,
JUNG ChanKwon,
WON Hye Sung,
HONG Sook Hee,
PARK Ji Chan,
ROH Sang Young,
WOO In Sook,
KANG Jin Hyoung,
HONG Young Seon,
BYUN Jae Ho
Publication year - 2010
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2010.01276.x
Subject(s) - medicine , hazard ratio , gastroenterology , malignancy , adenocarcinoma , pathological , stage (stratigraphy) , signet ring cell carcinoma , proportional hazards model , lymph node , carcinoma , signet ring cell , primary tumor , retrospective cohort study , disease , distant metastasis , cancer , metastasis , confidence interval , paleontology , biology
Aim: Primary adenocarcinoma of the appendix is a rare malignancy. This study assessed prognostic factors affecting the clinical outcome in patients with appendiceal neoplasms. Methods: We performed a retrospective analysis of patients who had appendectomies between 1991 and 2007 at five centers in South Korea. Results: Overall 55 patients (19 men, 36 women, median age 61 years) were identified. Of these, 37 (67.3%) were mucinous adenocarcinomas, 14 (25.5%) were intestinal‐type adenocarcinomas, and four (7.3%) were signet ring cell carcinomas. The distribution of stages was: 26 (47.3%) with localized disease, five (9.1%) with regional disease, and 24 (43.6%) with distant metastatic disease. The overall 3‐ and 5‐year survival rates among all patients were 72.2% and 64.0%, respectively, with 20 deaths during the follow‐up period. In a multivariate analysis, high histological grade (hazard ratio [HR] vs low grade 15.7; P = 0.001) and pathological stage (distant vs loco‐regional, HR 6.2; P = 0.021) were independent predictors of overall survival. Of the 34 patients who underwent curative resections of primary appendiceal carcinomas, the 3‐ and 5‐year disease‐free survival rates were 66.4% and 53.3%, respectively. The recurrence rate was higher in patients with regional lymph node metastasis (HR vs node negative disease 23.4; P = 0.005) and high‐grade tumors (HR vs low grade 6.3; P = 0.029). Additionally, a right hemicolectomy reduced the risk of recurrence (HR vs lesser procedures 0.05; P = 0.005). Conclusion: High tumor grade and advanced stage were significantly predictive of poor survival outcome in patients with primary appendiceal carcinomas.