Kazım Şenol1,2, Murat Ferhat Ferhatoğlu3, Deniz Tihan2,4. 1. Department of General Surgery, Uludağ University School of Medicine, Bursa, Turkey. 2. Department of General Surgery, Bursa High Specialty Training and Research Hospital, Bursa, Turkey. 3. Department of General Surgery, Okan University School of Medicine, İstanbul, Turkey. 4. Department of Anatomy, Uludağ University School of Medicine, Bursa, Turkey.
Abstract
OBJECTIVES: To evaluate the survival rates of appendiceal tumors and prognostic factors affecting survival. MATERIAL AND METHODS: Demographic features, tumor characteristics and pre- and post-operative outcomes of the patients were analyzed retrospectively. The study was performed according to the Helsinki declaration. RESULTS: Twenty-three of the 2840 specimens were investigated prospectively. Median age of the patients was 28 (range: 1-89) years, with a male (n= 1730, 60.9%) to female (n= 1110, 39.1%) ratio of 1.55. Pediatric group did not present appendiceal malignancy. Carcinoid tumors were reported in 17 (0.59%) and adenocarcinoma was reported in 6 (0.20%) patients. Multivariate analyses of the subtypes showed serosal invasion as an independent risk factor for mucinous and non-mucinous adenocarcinoma (HR: -2.70, 95% CI: 0.006-0.755, p= 0.029). Median follow-up time was 48 months (range: 28-61 months) and disease specific survival rates of carcinoid tumors, mucinous- and non-mucinous adenocarcinomas were 36(95% CI 32-40), 30 (95% CI 13-46), 43 (95% CI 30-55) months, respectively (p= 0.749). Factors affecting survival in the univariate analyses were advanced tumor stage, serosal invasion and tumor invasion depth. In multivariate analyses, tumor invasion depth was the only independent prognostic factor with poor survival rates in all subtypes of appendiceal malignancies (HR= 1.31 (95% CI: 1.01-13.5), p= 0.047). CONCLUSION: Tumor subtype and tumor invasiveness are important risk factors for survival. Besides other treatment modalities, appendectomy still remains the survival benefit with better clinical outcomes.
OBJECTIVES: To evaluate the survival rates of appendiceal tumors and prognostic factors affecting survival. MATERIAL AND METHODS: Demographic features, tumor characteristics and pre- and post-operative outcomes of the patients were analyzed retrospectively. The study was performed according to the Helsinki declaration. RESULTS: Twenty-three of the 2840 specimens were investigated prospectively. Median age of the patients was 28 (range: 1-89) years, with a male (n= 1730, 60.9%) to female (n= 1110, 39.1%) ratio of 1.55. Pediatric group did not present appendiceal malignancy. Carcinoid tumors were reported in 17 (0.59%) and adenocarcinoma was reported in 6 (0.20%) patients. Multivariate analyses of the subtypes showed serosal invasion as an independent risk factor for mucinous and non-mucinous adenocarcinoma (HR: -2.70, 95% CI: 0.006-0.755, p= 0.029). Median follow-up time was 48 months (range: 28-61 months) and disease specific survival rates of carcinoid tumors, mucinous- and non-mucinous adenocarcinomas were 36(95% CI 32-40), 30 (95% CI 13-46), 43 (95% CI 30-55) months, respectively (p= 0.749). Factors affecting survival in the univariate analyses were advanced tumor stage, serosal invasion and tumor invasion depth. In multivariate analyses, tumor invasion depth was the only independent prognostic factor with poor survival rates in all subtypes of appendiceal malignancies (HR= 1.31 (95% CI: 1.01-13.5), p= 0.047). CONCLUSION: Tumor subtype and tumor invasiveness are important risk factors for survival. Besides other treatment modalities, appendectomy still remains the survival benefit with better clinical outcomes.
Authors: Michael J Overman; Keith Fournier; Chung-Yuan Hu; Cathy Eng; Melissa Taggart; Richard Royal; Paul Mansfield; George J Chang Journal: Ann Surg Date: 2013-06 Impact factor: 12.969