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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
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Predicting Survival After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Appendix
Omer Aziz1,2, Ihab Jaradat1, Bipasha Chakrabarty1
1Colorectal & Peritoneal Oncology Centre, The Christie NHSFT, Manchester, United Kingdom.
Diseases of the Colon and Rectum
|May 18, 2018
Summary
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy improves survival for appendix adenocarcinoma. Key prognostic factors include peritoneal cancer index, cytoreduction completeness, and CEA levels, guiding treatment for this rare cancer.
Area of Science:
- Surgical Oncology
- Gastrointestinal Oncology
- Peritoneal Malignancies
Background:
- Appendix adenocarcinomas are rare and prone to peritoneal metastasis.
- Established treatment involves cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC).
- Previous survival studies lacked homogeneity in patient groups, interventions, and follow-up protocols.
Purpose of the Study:
- To quantify the survival impact of cytoreductive surgery with HIPEC in a homogeneous group of appendix adenocarcinoma patients.
- To identify prognostic indicators influencing survival in this specific patient cohort.
- To standardize treatment and follow-up for appendix adenocarcinoma.
Main Methods:
- Retrospective analysis of a prospective database from a national peritoneal tumor center.
- Standardized pathological review and multidisciplinary team management.
- Evaluation of prognostic indicators: Peritoneal Cancer Index (PCI), completeness of cytoreduction (CC) score, and preoperative tumor markers (CEA, CA19-9, CA125).
- Survival analysis using Kaplan-Meier curves and Cox regression.
Main Results:
- 65 patients with appendix adenocarcinoma underwent cytoreductive surgery with HIPEC (2005-2015).
- 5-year overall survival was 55.5%; disease event-free survival was 36.1%.
- Favorable prognostic factors: PCI <7, CC score of 0, and preoperative CEA <6.
- CA19-9 and CA125 levels did not significantly impact survival.
Conclusions:
- Cytoreductive surgery with HIPEC significantly impacts survival for appendix adenocarcinoma.
- PCI, CC score, and CEA are key prognostic indicators.
- Referral to specialized centers is crucial for managing these rare tumors.
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