Epidemiology of and prognostic factors for appendiceal carcinomas: a retrospective, population-based study
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The aim of this study is to evaluate the epidemiology of and prognostic factors for appendiceal carcinomas (ACs).
All cases of ACs registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2014 were retrospectively identified in this study. Age-adjusted incidence and survival rates were calculated.
We analyzed 7170 patients with ACs. We observed a significant increase in the reported annual age-adjusted incidence of ACs from 1973 (0.18/100,000) to 2014 (1.11/100,000). The elevation of the incidence was noted in all the histological types, stages, and grades. The most common histological type varied by race, with the appendiceal mucinous adenocarcinoma (AMA) being the most common in white, Asian/Pacific Islander, and American Indian/Alaskan Native patients, and the appendiceal adenocarcinoma (AA) being the most common in African American patients. In multivariate analysis of patients with all ACs, gender (P < 0.001), year of diagnosis (P < 0.001), age (P < 0.001), race (P < 0.001), tumor grade (P < 0.001), disease stage (P < 0.001), retrieved regional lymph nodes (P < 0.001), type of surgery performed (P = 0.002), and histologic subtype (P < 0.001) were predictors of outcome. Survival time for all ACs increased from the 1973–1993 period to the 1994–2014 period (HR 0.76; 95% CI, 0.69 to 0.85). Additionally, the 5-year survival rates were 88% for malignant carcinoid, 70% for goblet cell carcinoid, 51% for colonic type adenocarcinoma, 59% for mucinous adenocarcinoma, and 25% for signet ring cell type.
We observed increased reported incidence of ACs and increased survival durations over time, suggesting that clinicians pay more attention to ACs and mastering the characteristic of these tumors.
KeywordsAppendiceal carcinoma Epidemiology Incidence Survival outcomes Prognostic factors
The authors would like to thank the Surveillance, Epidemiology, and End Results (SEER) database for the support.
This study was supported by the National Key R&D Program of China (No. 2016YFC0905300 and 2016YFC0905301), the Grant of Science and Technology Commission of Shanghai Municipality (No. 16401970502), the Grant of National Natural Science Foundation of China (No. 81572351), the Shanghai Shenkang Program (No. SHDC12014206), the National Science Foundation of China (No. 81702353), and Shanghai Municipal Natural Science Foundation (17ZR1406400).
Compliance with ethical standards
Ethics approval and consent to participate
The Ethical Committee and Institutional Review Board of the Fudan University Shanghai Cancer Center reviewed and approved this study protocol.
The authors declare that they have no competing interests.
The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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