Faculty Collaboration Database

Importance of histologic subtype in the staging of appendiceal tumors. Ann Surg Oncol 2012 May;19(5):1379-85

Date

02/04/2012

Pubmed ID

22302267

DOI

10.1245/s10434-012-2238-1

Scopus ID

2-s2.0-84862516826 (requires institutional sign-in at Scopus site)   148 Citations

Abstract

BACKGROUND: Malignant neoplasms of the appendix have different behavior based on their histologic subtypes in anecdotal series. Current staging systems do not capture the diversity of histologic subtypes in predicting outcomes.

METHODS: We queried all patients with appendiceal malignancies captured in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2007. Tumors were classified as colonic type adenocarcinoma, mucinous adenocarcinoma, signet ring cell type, goblet cell carcinoid, and malignant carcinoid. We compared incidence, overall survival, and disease-specific survival for these tumors on the basis of patient, tumor, and therapy characteristics. Estimates from Cox proportional hazard modeling were used to predict hazard ratios for differing histologic subtypes with similar tumor, node, metastasis system (TNM) stages.

RESULTS: Of the 5672 patients identified, we included 5655 (99%) in our analysis. The 5-year disease-specific survival rates were 93% for malignant carcinoid, 81% for goblet cell carcinoid, 55% for colonic type adenocarcinoma, 58% for mucinous adenocarcinoma, and 27% for signet ring cell type. Predicted estimates of adjusted hazard ratios revealed an 8-fold difference between histologic subtypes for similar TNM stages.

CONCLUSIONS: Histologic subtype is an important predictor of disease-specific survival and overall survival in patients with appendiceal neoplasms. Addition of the histologic subtype to the TNM staging is simple and may improve prognostication.

Author List

Turaga KK, Pappas SG, Gamblin T

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adenocarcinoma, Mucinous
Adult
Aged
Appendiceal Neoplasms
Carcinoid Tumor
Carcinoma, Signet Ring Cell
Colectomy
Female
Humans
Incidence
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Prognosis
Survival Rate
United States
Young Adult