Published online Aug 15, 2023. doi: 10.4251/wjgo.v15.i8.1461
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
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.
To determine the epidemiologic and clinicopathological characteristics of MC.
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.
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.
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.
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.