Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2023; 15(8): 1461-1474
Published online Aug 15, 2023. doi: 10.4251/wjgo.v15.i8.1461
Epidemiologic characteristics and risk factors associated with overall survival for patients with mucinous colorectal cancer: A population-based study
Jiao Jiang, Xiao-Wei Tang, Shu Huang, Nan Hu, Yuan Chen, Bei Luo, Wen-Sen Ren, Yan Peng, Wei-Xing Yang, Mu-Han Lü
Jiao Jiang, Xiao-Wei Tang, Nan Hu, Yuan Chen, Bei Luo, Wen-Sen Ren, Yan Peng, Wei-Xing Yang, Mu-Han Lü, Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou 646099, Sichuan Province, China
Shu Huang, Department of Gastroenterology, the People’s Hospital of Lianshui, Huaian 223400, Jiangsu Province, China
Author contributions: Jiang J, Tang XW, and Huang S contributed equally to this work; Luo B, Hu N, Tang XW, and Chen Y designed the research study; Ren WS and Jiang J performed the data extraction; Jiang J, Tang XW, and Huang S analyzed the data and wrote the manuscript; Peng Y, Yang WX, and Lü MH revised the manuscript; All authors read and approved the final manuscript.
Supported by Science & Technology Department of Sichuan Province, No. 2021JDTD0003; and Scientific Research Cooperation Project of Suining First People’s Hospital and the Affiliated Hospital of Southwest Medical University, No. 2021SNXNYD05.
Institutional review board statement: This research project falls under the category of research conducted using lawfully obtained public data or data generated through observation without interfering with public behavior. Review and informed consent were exempted.
Informed consent statement: All data were downloaded from the “SEER Database,” and informed consents were exempted.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mu-Han Lü, MD, PhD, Full Professor, Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646099, Sichuan Province, China. lvmuhan@swmu.edu.cn
Received: April 17, 2023
Peer-review started: April 17, 2023
First decision: May 4, 2023
Revised: May 21, 2023
Accepted: June 13, 2023
Article in press: June 13, 2023
Published online: August 15, 2023
Processing time: 115 Days and 0.2 Hours
Abstract
BACKGROUND

Mucinous adenocarcinoma (MC) has attracted much attention as a distinct histologic subtype of colorectal cancer in recent years. However, data about its epidemiologic and prognostic characteristics are limited. Therefore, patient data extracted from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program were collected to analyze the epidemiologic and clinicopathological characteristics of MC.

AIM

To determine the epidemiologic and clinicopathological characteristics of MC.

METHODS

The incidence trend of MC was calculated through the Joinpoint Regression Program. Cox regression analyses were performed to identify prognostic factors associated with overall survival (OS). A nomogram was established to predict the survival probability of individual patients with MC.

RESULTS

We found that rates of MC decreased from 4.50/100000 in 2000 to 1.54/100000 in 2018. Rates of MCs in patients aged ≤ 50 years decreased 2.27%/year during 2000-2018. The incidence of appendiceal MCs increased from 0.14/100000 in 2000 to 0.24/100000 in 2018, while the incidence in other anatomic subsites continued to decrease. On multivariable Cox analyses, age, race, tumor site, T stage, N stage, M stage, surgery, and chemotherapy were associated with OS. A nomogram was developed based on these factors, and the area under the curve for 1-year, 3-year, and 5-year OS in the training cohort was 0.778, 0.778, and 0.768, respectively.

CONCLUSION

Our results demonstrated that MC incidence decreased in almost all anatomic subgroups except for the appendix. A nomogram predicting the survival probability of patients with MCs showed good performance.

Keywords: Mucinous adenocarcinoma; Colorectal cancer; Epidemiology; Prognostic factor; Nomogram; Surveillance epidemiology and end results database

Core Tip: When stratified by anatomic location, incidence rates declined in almost all anatomic subgroups except for mucinous adenocarcinoma in the appendix. Clinicians should also pay attention to the increasing incidence of appendiceal mucinous adenocarcinoma. During the survival analysis, we found that age, race, tumor site, surgery, and chemotherapy were significantly associated with survival. A nomogram based on those factors as well as the TNM tumor stages showed good predictive performance, which indicated that in addition to the TNM stages, characteristics such as tumor site, age, and race were also important in developing individualized treatment plans for patients with mucinous colorectal cancer.