title: The Management and Prognostic Prediction of Adenocarcinoma of Appendix.
abstract: 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.
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xie
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Zhangjian
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Yongchun
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Diao
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Chengxue
authors.initials: C
authors.lastname: Dang
authors.affiliation: Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 227W Yanta Road, Xi'an, 710061, Shaanxi, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001063:Appendiceal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D015996:Survival Rate