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) is a distinct histologic subtype of colorectal cancer (CRC), which differs from nonmucinous CRC in terms of clinicopathological characteristics and genetic features.
There are limited data about epidemiologic characteristics of MC, and little is known about the risk factors associated with the survival rates.
In this study, we aimed to determine the epidemiologic and clinicopathological characteristics of mucinous CRC.
We conducted a population-based analysis of the epidemiologic and clinicopathological characteristics of mucinous CRC on the basis of data extracted from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program.
Rates of mucinous CRC decreased from 4.50/100000 in 2000 to 1.54/100000 in 2018. Rates of mucinous CRCs in patients aged ≤ 50 years decreased 2.27%/year during 2000-2018, in sharp contrast to the upward trend in early-onset CRC. Incidence of appendiceal MCs increased from 0.14/100000 in 2000 to 0.24/100000 in 2018. On multivariable Cox analyses, age, race, tumor site, T stage, N stage, M stage, surgery, and chemotherapy were associated with overall survival. A nomogram was developed based on these factors, and the area under the curve for 1-year, 3-year, and 5-year overall survival in the training cohort was 0.778, 0.778 and 0.768, respectively, and was 0.805, 0.779 and 0.760 in the validation cohort, respectively.
We found that the incidence of mucinous CRC decreased both in young and older patients. However, the incidence of appendiceal MCs continued to increase. During the survival analysis, in addition to the TNM tumor stages, we found that age, race, tumor site, surgery, and chemotherapy were also significantly associated with survival. A nomogram based on these factors as well as the T, N, and M stages showed a good predictive performance.
We laid a foundation for future research exploring the prognostic implications of mucinous colorectal adenocarcinoma.