Comparison of long-term oncological outcomes of appendiceal cancer and colon cancer: A multicenter retrospective study. (March 2016)

• Record Type: Journal Article
• Authors: Son, Il Tae; Ahn, Soyeon; Park, Kyu Joo; Oh, Jae Hwan; Jeong, Seung-Yong; Park, Hyoung-Chul; Heo, Seung Chul; Youk, Eui Gon; Park, Jin-Taek; Ihn, Myong Hoon; Oh, Heung-Kwon; Kim, Duck-Woo; Lee, Kyoung Ho; Kang, Sung-Bum
• Is Part Of: Surgical oncology. Volume 25:Number 1(2016)
• Page Start: 37
• Page End: 43
• Publication Date: 2016-03
• Subjects: Appendiceal cancer -- Colon cancer -- Disease-free survival; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2015.12.006
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: There has been no comparative study of the long-term oncological outcomes of appendiceal cancer and colon cancer. We hypothesized that the oncological outcome is worse in appendiceal cancer because perforation is more frequent than in colon cancer. Methods: Patients with stage I–III were selected from 5046 patients with appendiceal or colon cancer, between September 2001 and June 2010. The 5-year disease-free survival (DFS) was the primary endpoint. Multivariate analyses with Cox proportional hazards model for DFS and logistic regression model for perforation were conducted. A matching model was used to compensate for the heterogeneity between groups. Results: The perforation rate was 44.7% in appendiceal cancer (n = 47), but 1.1% in colon cancer (n = 2828) ( p = 0.001). The 5-year DFS rate was lower in appendiceal cancer than in colon cancer (57.9% vs . 85.2%, p = 0.001; matching model, 54.2% vs . 78.4%, p = 0.038), with a higher rate of peritoneal seeding (25.5% vs . 2.5%, p = 0.001; matching model, 24.0% vs . 4.0%, p = 0.007). Multivariate Cox regression showed that appendiceal cancer was an independent prognostic factor for poor DFS (hazard ratio = 2.602, 95% confidence interval = 1.26–5.35, p = 0.009), and logistic regression confirmed that appendiceal cancer was the risk factor associated with perforation (odds ratio = 66.265, 95% confidence interval = 28.21–155.61, p = 0.001). Conclusions: This study suggested that the long-term oncological outcomes are worse for appendiceal cancer than for colon cancer, attributed to higher perforation rate in appendiceal cancer. Highlights: A comparative study for the oncologic outcomes of heterogeneous two malignancies. Worse oncologic outcome of appendiceal cancer compared with colon cancer. Perforation was associated with poor prognosis of appendiceal cancer.