BACKGROUND: Appendiceal cancer is a rare malignancy. The optimal pathologic classification and prognostic factors for survival and treatment strategies remain poorly understood. OBJECTIVE: The aim of this retrospective cohort study was to determine prognostic factors, including markers of systemic inflammation, for survival in a cohort of patients with advanced appendiceal adenocarcinomas. METHODS: The study included patients with advanced appendiceal carcinoma that were treated between January 2006 and June 2012. The associations between age, gender, histopathologic subtype of appendiceal malignancy and treatment with heated intraperitoneal chemotherapy (HIPEC) and overall survival (OS) were assessed. The relationship between various markers of inflammation (platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio) and OS was also evaluated. RESULTS: A total of 49 patients met eligibility criteria. Female gender and low-grade adenocarcinoma were associated with increased OS. These data suggest that the use of HIPEC treatment may also be associated with improved OS, but the difference was not statistically significant (HR = 0.37 [0.12-1.18], p = 0.09). We found no evidence of an association between markers of inflammation at diagnosis and OS. CONCLUSIONS: Histopathologic subtype and gender are associated with OS in patients with advanced appendiceal carcinoma. Baseline platelet levels, NLR, and PLR do not appear to be predictive of OS in this setting.
Bibliographical noteFunding Information:
Acknowledgments Funding for Fatima Khan, M.B.B.S., was supported by NIH T32 Hematology research training grant (5T32 HL00706). Funding for Rachel Isaksson Vogel was provided by NIH grant P30 CA77598 and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. Funding for Emil Lou was provided by the NIH Clinical and Translational Science KL2 Scholar Award 8UL1TR000114; Minnesota Masonic Charities; the Masonic Cancer Center and Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota; Institutional Research Grant #118198-IRG-58-001-52-IRG94 from the American Cancer Society; the Mezin-Koats Colon Cancer Research Award; the Litman Family Fund for Cancer Research; The Randy Shaver Cancer Research and Community Fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
- Appendiceal cancer
- Neutrophil-to-lymphocyte ratio
- Platelet-to-lymphocyte ratio
- Prognostic factors