ASO Visual Abstract: Validation of the AJCC 8th Edition Staging System for Disseminated Appendiceal Cancer Patients Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy-A Multi-institutional Analysis

被引：0

作者：

SenthilKumar, Gopika ^{[1
]}

Kothari, Anai N. ^{[1
]}

Maduekwe, Ugwuji N. ^{[1
]}

Fournier, Keith ^{[2
]}

Abbott, Daniel E. ^{[3
]}

Wilson, Gregory C. ^{[4
]}

Patel, Sameer H. ^{[4
]}

Greer, Jonathan ^{[5
]}

Johnston, Fabian ^{[5
]}

Dineen, Sean P. ^{[6
,7
]}

Powers, Benjamin D. ^{[6
,7
]}

Baumgartner, Joel ^{[8
]}

Veerapong, Jula ^{[8
]}

Leiting, Jennifer ^{[9
]}

Grotz, Travis E. ^{[9
]}

Maithel, Shishir K. ^{[10
]}

Staley, Charles ^{[10
]}

Raoof, Mustafa ^{[11
]}

Lambert, Laura ^{[12
]}

Lee, Andrew ^{[2
]}

Kim, Alex ^{[13
]}

Cloyd, Jordan M. ^{[13
]}

Mogal, Harveshp ^{[14
]}

机构：

[1] Med Coll Wisconsin, Dept Surg, Div Surg Oncol, Milwaukee, WI USA

[2] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX USA

[3] Univ Wisconsin, Div Surg Oncol, Dept Surg, Madison, WI USA

[4] Univ Cincinnati, Coll Med, Dept Surg, Cincinnati, OH USA

[5] Johns Hopkins Univ, Dept Surg, Baltimore, MD USA

[6] H Lee Moffitt Canc Ctr & Res Inst, Dept Gastrointestinal Oncol, Tampa, FL USA

[7] Morsani Coll Med, Dept Oncol Sci, Tampa, FL USA

[8] Univ Calif San Diego, Div Surg Oncol, Dept Surg, San Diego, CA USA

[9] Mayo Clin, Div Hepatobiliary & Pancreas Surg, Rochester, MN USA

[10] Emory Univ, Winship Canc Inst, Div Surg Oncol, Atlanta, GA USA

[11] City Hope Natl Med Ctr, Dept Surg, Div Surg Oncol, Duarte, CA USA

[12] Univ Utah, Dept Surg, Huntsman Canc Inst, Salt Lake City, UT USA

[13] Ohio State Univ, Dept Surg, Div Surg Oncol, Wexner Med Ctr, Columbus, OH USA

[14] Univ Washington, Dept Surg, Med Ctr, Seattle, WA 98195 USA

来源：

ANNALS OF SURGICAL ONCOLOGY | 2023年 / 30卷 / 09期

关键词：

AJCC 8th Edition; Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy; Disseminated appendiceal cancer;

D O I：

10.1245/s10434-023-13829-1

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: The AJCC 8th edition stratifies stage IV disseminated appendiceal cancer (dAC) patients based on grade and pathology. This study was designed to externally validate the staging system and to identify predictors of long-term survival. Methods: A 12-institution cohort of dAC patients treated with CRS ± HIPEC was retrospectively analyzed. Overall survival (OS) and recurrence-free survival (RFS) were analyzed by using Kaplan-Meier and log-rank tests. Univariate and multivariate cox-regression was performed to assess factors associated with OS and RFS. Results: Among 1009 patients, 708 had stage IVA and 301 had stage IVB disease. Median OS (120.4 mo vs. 47.2 mo) and RFS (79.3 mo vs. 19.8 mo) was significantly higher in stage IVA compared with IVB patients (p < 0.0001). RFS was greater among IVA-M1a (acellular mucin only) than IV M1b/G1 (well-differentiated cellular dissemination) patients (NR vs. 64 mo, p = 0.0004). Survival significantly differed between mucinous and nonmucinous tumors (OS 106.1 mo vs. 41.0 mo; RFS 46.7 mo vs. 21.2 mo, p < 0.05), and OS differed between well, moderate, and poorly differentiated (120.4 mo vs. 56.3 mo vs. 32.9 mo, p < 0.05). Both stage and grade were independent predictors of OS and RFS on multivariate analysis. Acellular mucin and mucinous histology were associated with better OS and RFS on univariate analysis only. Conclusions: AJCC 8th edition performed well in predicting outcomes in this large cohort of dAC patients treated with CRS ± HIPEC. Separation of stage IVA patients based on the presence of acellular mucin improved prognostication, which may inform treatment and long-term, follow-up strategies. © 2023, Society of Surgical Oncology.

引用

页码：5756 / 5757

页数：2