National trends in the presentation of surgically resected appendiceal adenocarcinoma over a decade.
BACKGROUND
Rates of nonoperative management of acute appendicitis and appendiceal adenocarcinoma have increased over a decade, but the presentation and outcomes of appendiceal adenocarcinoma over this period is not well-characterized.


METHODS
Patients with surgically resected Stage I-III appendiceal adenocarcinoma were identified from the 2006 to 2015 National Cancer Data Base and classified into two cohorts, 2006-2010 and 2011-2015, based on year of diagnosis. Three-year overall survival (OS) was analyzed using Cox proportional hazards regression and Kaplan-Meier survival estimates.


RESULTS
Of 4233 patients, 1369 (32.3%) and 2864 (67.7%) were diagnosed in 2006-2010 and 2011-2015, respectively. Following multivariable analysis, patients in 2011-2015 were more likely to be <40 years of age (6.4% vs. 4.7%, odds ratio [OR] 1.53, p .015), present with pT4 tumors (40.2% vs. 34.4%, OR 1.46, p .004), and undergo hyperthermic intraperitoneal chemotherapy (4.4% vs. 2.4%, OR 1.97, p .001). Comparing patients diagnosed in 2011-2015 to 2006-2010, adjusted 3-year OS was no different among all patients (81.1% vs. 79%, p .778).


CONCLUSIONS
There has been an increase in the proportion of patients with pT4 appendix tumors over time, primarily among older (≥60 years) patients. Even so, these shifts in presentation have not resulted in differences in survival outcomes.
['Shannon|Adrienne B|AB|https://orcid.org/0000-0002-7812-9627', 'Song|Yun|Y|', 'Roses|Robert E|RE|', 'Fraker|Douglas L|DL|', 'Miura|John T|JT|', 'Karakousis|Giorgos C|GC|']
D000230:Adenocarcinoma D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001062:Appendectomy D001063:Appendiceal Neoplasms D065426:Cytoreduction Surgical Procedures D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D018579:Patient Selection D011379:Prognosis D012189:Retrospective Studies D015996:Survival Rate D014481:United States D055815:Young Adult
appendix cancer cancer outcomes cancer trends oncologic outcomes oncologic trends peritoneal surface malignancy