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Ann Gastroenterol Surg. 2019 Feb 25;3(3):291-300. doi: 10.1002/ags3.12241. eCollection 2019 May.

Survival outcomes of appendiceal mucinous neoplasms by histological type and stage: Analysis of 266 cases in a multicenter collaborative retrospective clinical study.

Sueda T1,2, Murata K1,3, Takeda T1,4, Kagawa Y1,3, Hasegawa J1,2, Komori T1,5, Noura S1,6, Ikeda K1,7, Tsujie M1,8, Ohue M1,9, Ota H1,10, Ikenaga M1,11, Hata T1,4, Matsuda C1,4, Mizushima T1,4,12, Yamamoto H1,4,13, Sekimoto M1,14, Nezu R1,15, Mori M1,16, Doki Y1,4.

Author information

1
Colorectal Group Clinical Study Group of Osaka University (CSGO) Osaka Japan.
2
Department of Surgery Osaka Rosai Hospital Sakai Japan.
3
Department of Surgery Kansai Rosai Hospital Amagasaki Japan.
4
Department of Gastroenterological Surgery Osaka University Graduate School of Medicine Suita Japan.
5
Department of Surgery Osaka General Medical Center Osaka Japan.
6
Department of Surgery Toyonaka Municipal Hospital Toyonaka Japan.
7
Department of Surgery Minoh City Hospital Minoh Japan.
8
Department of Surgery Sakai City Medical Center Sakai Japan.
9
Department of Gastroenterological Surgery Osaka International Cancer Institute Osaka Japan.
10
Department of Surgery Ikeda City Hospital Ikeda Japan.
11
Department of Gastroenterological Surgery Higashiosaka City Medical Center Higashiosaka Japan.
12
Department of Therapeutics for Inflammatory Bowel Diseases Graduate School of Medicine Osaka University Suita Japan.
13
Division of Health Sciences Graduate School of Medicine Osaka University Suita Japan.
14
Department of Surgery National Hospital Organization Osaka National Hospital Osaka Japan.
15
Department of Surgery Nishinomiya Municipal Central Hospital Nishinomiya Japan.
16
Department of Surgery and Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan.

Abstract

Aim:

Appendiceal mucinous neoplasms are rare, and thus the literature is sparse with regard to histological types, staging, and prognosis. In particular, it is unclear how long-term outcome may differ between mucinous adenocarcinomas and other adenocarcinomas. In the present study, we aimed to investigate the histological types and stages of appendiceal neoplasms, and to evaluate the prognostic impacts of these factors in patients with mucinous adenocarcinomas and non-mucinous adenocarcinomas.

Methods:

Patients with appendiceal tumors diagnosed between 2007 and 2016 were retrospectively identified from the databases of 19 institutions in the Clinical Study Group of Osaka University, Colorectal Group.

Results:

A total of 266 patients with appendiceal tumors were identified, of whom 130 had pathologically diagnosed adenocarcinomas, including 57 with mucinous adenocarcinomas and 73 with non-mucinous adenocarcinomas. Five-year overall survival (OS) rates were 64.5% for mucinous adenocarcinomas, and 49.0% for non-mucinous adenocarcinomas. OS was significantly shorter among patients with non-mucinous adenocarcinomas compared to mucinous adenocarcinomas. Among patients with mucinous adenocarcinomas, 5-year OS rates were 53.6% for stage 0/I, 82.6% for II/III, and 48.4% for IV. Among patients with non-mucinous adenocarcinomas, 5-year OS rates were 90.9% for stage 0/I, 68.8% for II/III, and 7.1% for IV. Analysis of patients with stage IV disease revealed significantly shorter OS among patients with non-mucinous adenocarcinomas compared to mucinous adenocarcinomas.

Conclusion:

Our present findings showed a better prognosis in patients with mucinous adenocarcinomas compared to non-mucinous adenocarcinomas. In this setting, Union for International Cancer Control staging was associated with prognosis for non-mucinous adenocarcinomas, but not for mucinous adenocarcinomas.

KEYWORDS:

appendiceal carcinoma; mucinous; non‐mucinous; prognosis; survival outcomes

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