Advertisement

Indian Journal of Gastroenterology

, Volume 35, Issue 5, pp 354–360 | Cite as

Elevated risk of subsequent malignancies in patients with appendiceal cancer: A population-based analysis

  • Adil Ayub
  • Om Parkash
  • Norberto Santana-Rodríguez
  • Wissam Raad
  • Faiz Y. Bhora
Original Article

Abstract

Background

Appendiceal cancer is extremely rare with excellent survival after curative resection. There is a concern for the development of additional cancers in survivors of appendiceal cancer. However, existing data is limited to small anecdotal reports on appendiceal carcinoid only. We aim to investigate the risk of subsequent malignancies in patients with appendiceal carcinoma and correlate the risk according to patient and clinical characteristics.

Methods

We identified 3788 patients with appendiceal cancer from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database between 1992 and 2011. Standardized incidence ratios (SIRs) for the risk of additional cancers were calculated and quantified based on tumor site, gender, race, latency, primary tumor stage, and histology.

Results

Three hundred and fifty-nine subsequent malignancies were identified in 313 patients (mean age 60 years, male to female ratio 1.3:1). The overall risk for a subsequent malignancy was elevated by 20 % compared with the general population. Most common sites with significantly increased risk for subsequent cancers included the small intestine (n=13) and the colon/rectum (n=48). Malignant carcinoid and adenocarcinoma were the dominant histological subtypes at these sites, respectively. Significant elevated risk was observed within the first 5 years of follow up in white males with either localized or regional disease. Adenocarcinomas and goblet cell carcinoid tumors of the appendix were associated with increased risk; whereas, the risk was significantly reduced in patients with malignant carcinoid tumors.

Conclusion

There is an increased risk of subsequent cancers in patients with appendiceal carcinoma.

Keywords

Additional tumors Appendiceal cancer Second malignancy SEER 

Notes

Compliance with ethical standards

Conflict of interest

AA, OP, NS-R, WR, and FYB declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights, and the authors followed the policy concerning Informed consent as shown on Springer.com.

References

  1. 1.
    Hesketh KT. The management of primary adenocarcinoma of the vermiform appendix. Gut. 1963;4:158–68.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Moertel CG, Weiland LH, Nagorney DM, Dockerty MB. Carcinoid tumor of the appendix: treatment and prognosis. N Engl J Med. 1987;317:1699–701.CrossRefPubMedGoogle Scholar
  3. 3.
    Pape UF, Perren A, Niederle B, et al. ENETS consensus guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas. Neuroendocrinology. 2012;95:135–56.CrossRefPubMedGoogle Scholar
  4. 4.
    Adil SR, Meyerhardt JA. Cancer of the appendix and pseudomyxoma peritonei. In: UpToDate, Tanabe KK (Ed), UpToDate, Waltham, MA. Accessed 23 March 2016.Google Scholar
  5. 5.
    Landry CS, Woodall C, Scoggins CR, McMasters KM, Martin RC 2nd. Analysis of 900 appendiceal carcinoid tumors for a proposed predictive staging system. Arch Surg. 2008;143:664–70 .discussion 670CrossRefPubMedGoogle Scholar
  6. 6.
    Morton LM, Onel K, Curtis RE, Hungate EA, Armstrong GT. The rising incidence of second cancers: patterns of occurrence and identification of risk factors for children and adults. American Society of Clinical Oncology educational book / ASCO. American Society of Clinical Oncology. Meeting. 2014:e57–67.Google Scholar
  7. 7.
    Brunner AM, Hobbs G, Jalbut MM, Neuberg DS, Fathi AT. A population-based analysis of second malignancies among patients with myeloproliferative neoplasms in the SEER database. Leuk Lymphoma. 2016;57:1197–200.PubMedGoogle Scholar
  8. 8.
    Lee JS, DuBois SG, Coccia PF, Bleyer A, Olin RL, Goldsby RE. Increased risk of second malignant neoplasms in adolescents and young adults with cancer. Cancer. 2016;122:116–23.CrossRefPubMedGoogle Scholar
  9. 9.
    Fernandez KS, Aldrink JH, Ranalli M, Ruymann FB, Caniano DA. Carcinoid tumors in children and adolescents: risk for second malignancies. J Pediatr Hematol Oncol. 2015;37:150–3.CrossRefPubMedGoogle Scholar
  10. 10.
    Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 9 Regs Research Data, Nov 2014 Sub (1973–2012) < Katrina/Rita Population Adjustment > − Linked To County Attributes - Total U.S., 1969–2013 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2015, based on the November 2014 submission.
  11. 11.
    Tamboli D, Topham A, Singh N, Singh AD. Retinoblastoma: a SEER dataset evaluation for treatment patterns, survival, and second malignant neoplasms. Am J Ophthalmol. 2015;160:953–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Turaga KK, Pappas SG, Gamblin T. Importance of histologic subtype in the staging of appendiceal tumors. Ann Surg Oncol. 2012;19:1379–85.CrossRefPubMedGoogle Scholar
  13. 13.
    Habal N, Sims C, Bilchik AJ. Gastrointestinal carcinoid tumors and second primary malignancies. J Surg Oncol. 2000;75:310–6.CrossRefPubMedGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2016

Authors and Affiliations

  • Adil Ayub
    • 1
  • Om Parkash
    • 2
  • Norberto Santana-Rodríguez
    • 1
  • Wissam Raad
    • 1
  • Faiz Y. Bhora
    • 1
  1. 1.Division of Thoracic Surgery, Department of Surgery, Icahn School of MedicineMount Sinai Health SystemNew YorkUSA
  2. 2.Department of GastroenterologyThe Aga Khan University HospitalKarachiPakistan

Personalised recommendations