A Nomogram for Predicting Lymph Nodal Metastases in Patients with Appendiceal Cancers: An Analysis of SEER Database. Issue 8 (22nd July 2021)

• Record Type: Journal Article
• Authors: Wang, Dan; Liu, Chongshun; Yan, Tingyu; Li, Chenglong; Güngör, Cenap; Yang, Qionghui; Xu, Yang; Zhao, Lilan; Pei, Qian; Tan, Fengbo; Li, Yuqiang
• Is Part Of: Journal of investigative surgery. Volume 34:Issue 8(2021)
• Page Start: 924
• Page End: 930
• Publication Date: 2021-07-22
• Subjects: Appendiceal cancer -- nodal metastases -- surveillance epidemiology and end results database -- nomogram -- right hemicolectomy -- metastases; Surgery -- Research -- Periodicals; Research; Surgery; Surgical Procedures, Operative; 617.075
• DOI: 10.1080/08941939.2019.1711467
• Languages: English
• ISSNs: 0894-1939

Abstract

Abstract: Backgrounds: Appendiceal cancers are usually diagnosed after appendectomy accidentally. The need for subsequent right hemicolectomy in these patients was determined by the potential risk of regional lymph node (LN) metastasis. Establishing a nomogram to forecast the potential risk of lymph node metastasis of appendiceal cancer could help in the next step of treatment. Methods: Patients with appendiceal cancer undergoing surgery was queried in the American cancer database of Surveillance, Epidemiology and End Results database from 2004 to 2016. A nomogram was established based on Logistic regression model. Results: Finally, 3, 075 patients were diagnosed with appendectomy cancer from 2004 to 2016. Among them, there were 2028 (65.9%) cases with negative lymph nodes, 1047 (34.1%) cases with positive lymph nodes. Risk factors associated with lymph node metastasis include age, histological type, tissue grade, T stage, distant metastasis, and tumor size. We drew the ROC curves of the training group（0.754, P < 0.001） and the validation group （0.775, P < 0.001） respectively. C-index values of predictions were 0.772 (95%CI, 0.750-0.793) and 0.776 (95%CI, 0.746-0.807), and Brier score were 0.178 and 0.172 in training and validation group respectively. All of them showed excellent performance of the nomogram in our study. Conclusion: A new nomogram was created to assess the potential risk of LN metastasis in patients of appendiceal cancer by utilizing age, tumor histology, tumor pathologic grade, tumor size, T-stage, and M-stage. The nomogram could provide a strong reference for the right hemicolectomy and facilitate clinic decision.