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Article Abstract
Introduction: Appendiceal neuroendocrine neoplasms are rare lesions which are generally incidentally discovered during or after appendectomies. Recent advances have refined their classification and improved diagnostic rates, highlighting their distinct pathologic and clinical presentations. The present study aimed to assess the characteristics and outcomes of appendiceal neuroendocrine neoplasms using data from the U.S. National Cancer Database.
Methods: This retrospective cohort analysis included patients with stage I-III appendiceal neuroendocrine neoplasms who underwent surgical treatment. Data were obtained from the National Cancer Database from 2005 to 2019 and were analyzed for patient demographics, tumor characteristics, treatment modalities, and survival outcomes. The main outcome was 5-year overall survival. Multivariable Cox regression analyses were used to assess the independent predictors of 5-year overall survival.
Results: Overall, 2,657 patients (predominantly White, 88.1%; female, 58.5%; average age, 49 years) were included in this study. A total of 54% of tumors were low-grade and 83.3% were well-differentiated. Surgical treatments included segmental resections (40.5%), subtotal colectomies (33.9%), appendectomies (24.3%), and total colectomies (1.3%). Older age (hazard ratio = 1.06, P < .001), higher tumor grade (hazard ratio = 3.48, P = .003), and advanced disease stage (hazard ratio = 4.73, P = .002) were significantly associated with decreased survival. In contrast, a laparoscopic approach to surgery (hazard ratio = 0.50, P = .003) and private insurance (hazard ratio = 0.017, P = .018) were associated with improved survival.
Conclusion: This study's clinicopathologic findings align with prior research on appendiceal neuroendocrine neoplasms. Older age, higher tumor grade, and advanced disease stage were associated with poorer survival outcomes. The results emphasize the significance of early detection and the advantages of minimally invasive surgeries in enhancing patient prognosis.
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| http://dx.doi.org/10.1016/j.surg.2025.109645 | DOI Listing |
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