The Management and Prognostic Prediction of Adenocarcinoma of Appendix

Malignant tumours of the appendix are quite rare, especially appendiceal adenocarcinomas, which may be difficult to detect preoperatively or intraoperatively. We collected data for 1404 patients with adenocarcinoma of the appendix from the Surveillance, Epidemiology, and End Results Program (SEER) d...

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Bibliographic Details
Published in:Scientific reports 2016-12, Vol.6 (1), p.39027-39027, Article 39027
Main Authors: Xie, Xin, Zhou, Zhangjian, Song, Yongchun, Li, Wenhan, Diao, Dongmei, Dang, Chengxue, Zhang, Hao
Format: Article
Language:English
Subjects:
631/67/1059
631/67/1504
Adenocarcinoma
Appendix
Cancer
Chemotherapy
Epidemiology
Gastrointestinal cancer
Humanities and Social Sciences
Medical prognosis
Metastases
multidisciplinary
Nomograms
Prediction models
Science
Survival
Tumors
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Summary:Malignant tumours of the appendix are quite rare, especially appendiceal adenocarcinomas, which may be difficult to detect preoperatively or intraoperatively. We collected data for 1404 patients with adenocarcinoma of the appendix from the Surveillance, Epidemiology, and End Results Program (SEER) database to explore the potential associations between clinicopathological factors and overall survival. Furthermore, a novel nomogram for predicting prognosis was developed based on our analysis of the SEER data. The nomogram prediction model included seven prognostic factors derived based on different clinical estimates. When compared with the traditional tumour-node-metastasis (TNM) staging system, the nomogram prediction model showed superior discriminatory power (Harrell’s C-index, 0.741 vs. 0.686) and a greater degree of similarity to actual 5-year overall survival after calibration (Akaike Information Criterion index, 5270.781 vs. 5430.141). Finally, we provide recommendations for the management of patients with adenocarcinoma of the appendix. Notably, we found the depth of adenocarcinoma invasion may be used as an indicator to determine the optimal surgical approach. For mucinous adenocarcinomas of the appendix, because these tumours are characterized by unique biological behaviour, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is recommended. However, whether systematic chemotherapy should be administered to patients with adenocarcinoma of the appendix requires further investigation.
ISSN:2045-2322
2045-2322
DOI:10.1038/srep39027