Nomogram to predict overall survival and disease-specific survival with appendiceal mucinous adenocarcinoma

Yan, Qian; Zheng, Weipeng; Chen, Qing Lian; Wang, Bo Qing; Luo, Hui; Xue, Jiao; Wang, Xiong Wen

doi:10.1097/md.0000000000017332

Cited by 8 publications

(6 citation statements)

References 24 publications

(29 reference statements)

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“…Several obvious advantages can be found in this study compared with previous studies that established appendiceal cancer nomograms. First of all, we are the first to build nomograms specifically for the survival of patients with appendiceal cancer after surgery, while the previous nomograms did not specifically serve postoperative patients and was limited to mucinous adenocarcinoma (Xie et al 2016;Yan et al 2019). Furthermore, compared to the previous two studies which only included 1404 and 3234 patients (Xie et al 2016;Yan et al 2019), our nomogram was based on a larger data study, which included 5945 patients, and was validated in 1982 patients.…”

Section: Discussionmentioning

confidence: 99%

“…First of all, we are the first to build nomograms specifically for the survival of patients with appendiceal cancer after surgery, while the previous nomograms did not specifically serve postoperative patients and was limited to mucinous adenocarcinoma (Xie et al 2016;Yan et al 2019). Furthermore, compared to the previous two studies which only included 1404 and 3234 patients (Xie et al 2016;Yan et al 2019), our nomogram was based on a larger data study, which included 5945 patients, and was validated in 1982 patients. Second, we included more commonly used prognostic factors in clinical practice compared with previous nomograms, such as preoperative CEA, chemotherapy and tumor size, which means that the prognosis of patients with appendiceal cancer can be more accurately predicted.…”

Section: Discussionmentioning

confidence: 99%

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Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

et al. 2021

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In order to establish nomograms that could forecast the postoperative survival for patients with appendiceal cancer after surgery, this study collected 5945 patients with surgically removed appendiceal cancer from the Surveillance, Epidemiology, and End Results database. Overall survival (OS) and cancer-specific survival (CSS) were analyzed by Cox regression analysis and nomograms. The population was randomly separated into a training group (n = 3963) and a validation group (n = 1982). Age, histological grade, T stage, N stage, regional nodes examination, tumor size, and CEA were independent prognostic factors for OS and were used in the nomogram. In addition, radiotherapy and chemotherapy were independent prognostic factors for CSS. The C-index values of the nomograms predicting postoperative OS and CSS were 0.76 (95% CI 0.74-0.78) and 0.80 (95% CI 0.78-0.82) in the training group and 0.77 (95% CI 0.74-0.79) and 0.81 (95% CI 0.78-0.84) in the validation group. Moreover, nomograms were better than traditional American Joint Committee on Cancer (AJCC) TNM 8th Edition Staging System in predicting prognosis derived from the results of DCA and ROC curves. In a word, we constructed new nomograms based on a large database that can accurately predict the OS and CSS of patients with appendiceal cancer after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

et al. 2021

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“…The documented rate of LN+ in MAC is variable and there have been equivocal findings as to whether mucinous histology is itself an independent risk factor of LN+ 22‐24 . To our knowledge, no study has investigated the risk factors of LN+ in patients with MAC, though previous investigations evaluating all patients with appendiceal cancers (adenocarcinomas and neuroendocrine tumors) have shown that grade is strongly associated with increased rates of LN+ and worse survival outcomes 2,14,15,23,24 . LN+ is often considered less common in MAC; this study identifies an appreciable rate of LN+ among all MAC patients and a particularly high rate of LN+ in certain subgroups.…”

Section: Discussionmentioning

confidence: 67%

“…MAC has one of the lowest LN+ rates of all appendiceal neoplasms, varying from 4% to 20% in the current literature 2,7,14‐16 . Even among patients with MAC having peritoneal dissemination, the risk of LN+ is 6% in low‐ to moderate‐grade disease, but rises to 29% among high‐grade disease patients 12 .…”

Section: Introductionmentioning

confidence: 94%

Predictors of lymph node metastases in patients with mucinous appendiceal adenocarcinoma

Shannon

Goldberg

Song

et al. 2020

Journal of Surgical Oncology

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Background Lymph node metastasis (LN+) is a prognostic factor in appendiceal cancers, but predictors and outcomes for LN+ in mucinous appendiceal adenocarcinoma (MAC) remain poorly defined. Methods Patients were identified from the 2010 to 2016 NCDB who underwent surgical resection as first‐line management for Stage I‐III mucinous appendiceal cancer. A LN+ risk‐score model was developed using multivariable regression on a training data set and internally validated using a testing data set. Three‐year overall survival (OS) was analyzed by Cox proportional hazards regression. Results Of 1158 patients, LN+ (N = 244, 21.1%) patients were more likely to have higher pT group and grade of disease, lymphovascular invasion (LVI), and positive margins on univariate analyses. Predictive factors associated with LN+ on multivariable analysis included positive surgical margins (odds ratio [OR] 3.00, P <.0001), higher grade (moderately differentiated: OR, 2.16, P < .0001; poorly or undifferentiated: OR, 3.07, P < .0001), and LVI (OR, 7.28, P < .0001). A validated risk‐score model using these factors was developed with good performance (AUC 0.749). LN+ patients had a worse 3‐year OS compared with LN− patients (17.4% vs 82.6%, hazard ratio 1.96, P = .001). Conclusions LN+ is associated with worse survival in patients with MAC. A risk‐score model using margin status, LVI, and grade can accurately risk stratify patients for LN+.

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“…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…”

Section: Introductionmentioning

confidence: 99%

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

Chen

Rotundo

et al. 2023

BMJ Open Gastroenterol

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ObjectiveAlthough appendiceal cancer remains a rare gastrointestinal malignancy compared with colorectal cancer, incidence rates of appendiceal cancer have increased in the last two decades. Appendiceal and cecal adenocarcinomas have distinct genomic profiles, but chemotherapy protocols for these malignancies are the same and survival outcomes between them have not been compared extensively. To this end, we conducted a comparative survival analysis of appendiceal and cecal adenocarcinomas.DesignUsing the Surveillance, Epidemiology and End Results (SEER) database, we identified individuals ≥30 years of age with appendiceal or cecal adenocarcinoma from 1975 to 2016. Demographic, clinical and county-level socioeconomic data were extracted using SEER*Stat software. Survival was compared by Mantel-Haenszel log-rank test, and survival curves were generated using the Kaplan-Meier method. Relative HRs for death in the 5-year period following diagnosis were calculated using multivariable Cox regression analysis, adjusted for all other covariates. The significance level was set at p<0.05 for two-tailed tests. Data were analysed using SAS V.9.4 and R software.ResultsWe identified 6491 patients with appendiceal adenocarcinoma and 99 387 patients with cecal adenocarcinoma. Multivariable Cox regression analysis demonstrated significantly higher cancer-specific and overall survival in appendiceal adenocarcinoma compared with cecal adenocarcinoma. Male sex, older age, earlier year of diagnosis, black race, single marital status, non-Hispanic ethnicity, and non-mucinous histology were associated with increased mortality rates. In addition, counties with lower percentage of individuals below the poverty line and higher colorectal cancer screening rates had better survival.ConclusionThis is the first study to show greater survival in appendiceal adenocarcinoma compared with cecal adenocarcinoma. We also highlighted novel associations of county-level socioeconomic factors with increased mortality in appendiceal adenocarcinoma. Future efforts to develop targeted molecular therapies and reduce socioeconomic barriers to diagnosis and treatment are warranted to improve survival.

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Nomogram to predict overall survival and disease-specific survival with appendiceal mucinous adenocarcinoma

Cited by 8 publications

References 24 publications

Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

Predictors of lymph node metastases in patients with mucinous appendiceal adenocarcinoma

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

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