Clinical characteristics and prognostic factors for primary appendiceal carcinoma.
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.
Ko
Yoon Ho
YH
Division of Oncology, Department of Internal Medicine, Catholic University, Seoul, Korea.
Park
Se Hoon
SH
Jung
Chan-Kwon
CK
Won
Hye Sung
HS
Hong
Sook Hee
SH
Park
Ji Chan
JC
Roh
Sang Young
SY
Woo
In Sook
IS
Kang
Jin Hyoung
JH
Hong
Young Seon
YS
Byun
Jae Ho
JH
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