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Surg Oncol. 2016 Mar;25(1):37-43. doi: 10.1016/j.suronc.2015.12.006. Epub 2015 Dec 30.

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

Author information

1
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
2
Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, South Korea.
3
Department of Surgery, Seoul National University Hospital, Seoul, South Korea.
4
Center for Colorectal Cancer, National Cancer Center, Goyang, South Korea.
5
Department of Surgery, Hallym University College of Medicine, Hallym University Hospital, Anyang, South Korea.
6
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea.
7
Department of Surgery, Daehang Hospital, Seoul, South Korea.
8
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.
9
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: kangsb@snubh.org.

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.

KEYWORDS:

Appendiceal cancer; Colon cancer; Disease-free survival

PMID:
26979639
DOI:
10.1016/j.suronc.2015.12.006
[Indexed for MEDLINE]

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