title: Clinical characteristics and prognostic factors for primary appendiceal carcinoma.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  High tumor grade and advanced stage were significantly predictive of poor survival outcome in patients with primary appendiceal carcinomas.
authors.affiliation: Division of Oncology, Department of Internal Medicine, Catholic University, Seoul, Korea.
authors.forename: Yoon Ho
authors.initials: YH
authors.lastname: Ko
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.forename: Hye Sung
authors.initials: HS
authors.lastname: Won
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Hong
authors.forename: Ji Chan
authors.initials: JC
authors.lastname: Park
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Roh
authors.forename: In Sook
authors.initials: IS
authors.lastname: Woo
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
authors.forename: Young Seon
authors.initials: YS
authors.lastname: Hong
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Byun
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D001063:Appendiceal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies