Clinicopathologic characteristics, management, and outcomes of different types of appendiceal cancer: a National...

The incidence of appendiceal cancer has increased over the last 2 decades. The current study aimed to investigate the overall survival and prognostic factors of appendiceal cancer using the National Cancer Database (NCDB).

We used the NCDB (2004-2020) in the current retrospective analysis to include patients with appendiceal cancer. We meticulously selected histologies that corresponded to goblet cell adenocarcinoma (GCA), neuroendocrine neoplasm (NEN), nonmucinous adenocarcinoma (NMA), and mucinous adenocarcinoma (MA).

The GCA, MA, NEN, and NMA groups consist of 6111, 16,471, 19,199, and 11,065 patients, respectively. The NMA group had significantly lower overall survival (101.40 months; 95% CI, 99.13-103.67) than the other groups (P <.001). The NEN group had significantly higher overall survival (170.88 months; 95% CI, 168.56-173.20) than the other groups (P <.001). Importantly, NMA type of appendiceal tumor (hazard ratio [HR], 1.37; reference, GCA), intraoperative chemotherapy (HR, 0.60; reference, neoadjuvant therapy), and laparoscopic approach surgery (HR, 0.74; reference, open approach) were independent predictors of overall survival in patients with appendiceal cancer.

Our study revealed that NMA and NEN types had the poorest and best overall survival rates, respectively, compared with other types. In addition, intraoperative systemic therapy and laparoscopic approach surgery were independently associated with better survival in patients with appendiceal cancer.