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Purpose <p>Few studies have evaluated whether the timing of colectomy affects the prognosis of appendiceal cancer. This study compared long-term outcomes and recurrence patterns between initial appendectomy followed by two-stage colectomy and one-stage colectomy for appendiceal cancer.</p> Methods <p>We retrospectively evaluated 65 patients who underwent 2-stage (<i>n</i> = 17) or 1-stage (<i>n</i> = 48) right-sided colectomy with lymph node dissection for stage 0–III appendiceal cancer between August 2005 and December 2022. The recurrence types and risk factors were compared.</p> Results <p>The 2-stage colectomy group had a more advanced disease stage than the 1-stage group (stage III cases: 29.4% vs. 14.6%, <i>P</i> = 0.03). The 5-year overall recurrence rates were similar between the groups (29.4% vs. 19.2%, <i>P</i> = 0.39). All peritoneal recurrence cases (<i>n</i> = 9) had pT3 or T4 depth. Among pT3 and T4 cases (<i>n</i> = 46), the peritoneal recurrence rates did not differ significantly (31.2% vs. 13.8%, <i>P</i> = 0.17). A multivariate analysis identified preoperative serum CA19-9 level of &gt; 37 ng/mL (hazard ratio [HR], 35.4; 95% confidence interval [CI], 3.08–406.8; <i>P</i> = 0.004) and lymph node metastasis (HR, 42.6; 95% CI, 9.90–183.6; <i>P</i>&#xa0;&lt;&#xa0;0.001) as independent risk factors for peritoneal recurrence.</p> Conclusions <p>Serum CA19-9 levels and lymph node metastasis are risk factors for peritoneal recurrence. The effect of colectomy timing on recurrence was not definitive.</p>

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Appendectomy followed by two-stage right-sided colectomy with lymph node dissection for appendiceal cancer and risk factors for peritoneal recurrence: a single high-volume cancer center study in Japan

  • 期刊论文

  • 发表日期：

    2025年3月28日

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  • Kentaro Sato,
  • Shimpei Matsui,
  • Manabu Takamatsu,
  • Tatsuki Noguchi,
  • Takashi Sakamoto,
  • Toshiki Mukai,
  • Tomohiro Yamaguchi,
  • Takashi Akiyoshi

摘要

Purpose

Few studies have evaluated whether the timing of colectomy affects the prognosis of appendiceal cancer. This study compared long-term outcomes and recurrence patterns between initial appendectomy followed by two-stage colectomy and one-stage colectomy for appendiceal cancer.

Methods

We retrospectively evaluated 65 patients who underwent 2-stage (n = 17) or 1-stage (n = 48) right-sided colectomy with lymph node dissection for stage 0–III appendiceal cancer between August 2005 and December 2022. The recurrence types and risk factors were compared.

Results

The 2-stage colectomy group had a more advanced disease stage than the 1-stage group (stage III cases: 29.4% vs. 14.6%, P = 0.03). The 5-year overall recurrence rates were similar between the groups (29.4% vs. 19.2%, P = 0.39). All peritoneal recurrence cases (n = 9) had pT3 or T4 depth. Among pT3 and T4 cases (n = 46), the peritoneal recurrence rates did not differ significantly (31.2% vs. 13.8%, P = 0.17). A multivariate analysis identified preoperative serum CA19-9 level of > 37 ng/mL (hazard ratio [HR], 35.4; 95% confidence interval [CI], 3.08–406.8; P = 0.004) and lymph node metastasis (HR, 42.6; 95% CI, 9.90–183.6; P < 0.001) as independent risk factors for peritoneal recurrence.

Conclusions

Serum CA19-9 levels and lymph node metastasis are risk factors for peritoneal recurrence. The effect of colectomy timing on recurrence was not definitive.