Retrospective Cohort Study
Copyright ©The Author(s) 2017.
World J Gastrointest Oncol. Sep 15, 2017; 9(9): 354-362
Published online Sep 15, 2017. doi: 10.4251/wjgo.v9.i9.354
Table 1 Baseline clinical and pathological characteristics of the 265 patients with mucinous appendiceal adenocarcinoma treated with cytoreduction and hyperthermic intraperitoneal chemotherapy stratified by histological grade n (%)
Characteristics of the entire cohort (n = 265)Well-differentiated (n = 201)Moderately-differentiated (n = 45)Poorly-differentiated (n = 19)TotalP value
Age53.1 (45-59)54.9 (46-59)49.6 (45-60)53.4 (45-59)P = 0.963
SexP = 0.622
Male78 (39)21 (47)8 (42)107 (40.4)
Female123 (61)24 (53)11 (58)158 (59.6)
Signet ring cellP < 0.00112
> 50%03 (7)11 (58)14 (5.3)
1%-50%6 (3)4 (9)010 (3.8)
None195 (97)38 (84)8 (42)241 (90.9)
LVIP < 0.00112
Yes3 (1)8 (18)9 (47)20 (7.5)
No198 (98)35 (78)3 (16)241 (90.9)
LN involvementP < 0.00112
Yes11 (5)4 (9)8 (42)23 (8.7)
No160 (80)38 (84)4 (21)208 (78.5)
Neoadjuvant chemoP < 0.00112
Yes29 (14)21 (47)15 (79)65 (24.5)
No172 (86)24 (53)4 (21)200 (75.5)
Adjuvant chemoP < 0.00112
Yes12 (6)3 (7)8 (42)23 (8.7)
No189 (94)42 (93)11 (58)242 (91.3)
PSSP = 0.0522
077 (38)20 (44)7 (37)104 (39.2)
159 (29)13 (29)3 (16)75 (28.3)
244 (22)6 (13)9 (47)59 (22.3)
321 (10)6 (13)027 (10.2)
Albumin4.2 (4.0-4.4)4.3 (4.1-4.5)4.2 (4.0-4.9)4.2 (4.1-4.5)P = 0.773
CEA2.8 (1.3-10.7)4.5 (2.4-15.7)2.2 (1.4-4.9)3.4 (1.5-10.5)P = 0.923
PCI17.5 (11-26)14 (8-24)15.5 (12-25)16.5 (10-25)P = 0.453
Completeness of cytoreductionP = 0.322
CC 0-1176 (88)40 (89)15 (79)231 (87.2)
CC 2-319 (9)5 (11)4 (21)28 (10.6)
Unknown6 (2.3)
OR time9.2 (7.7-11.4)8.7 (6.9-10.0)7.9 (6.9-10.5)8.9 (7.5-11.1)P = 0.823
Blood loss600 (350-997)375 (250-588)350 (250-550)500 (300-900)P = 0.00713
LOS19 (13-27)13 (10-22)16 (10-23)17 (12-26)P = 0.00813
30 d morbidity any grade108 (54)28 (68)11 (58)149 (55)P = 0.492
90 d grade III/IV35 (17)14 (31)2 (10)51 (19.2)P = 0.352
90 d mortality2 (1)002 (0.8)P = 0.732
Table 2 Univariate and Multivariate models using Cox regression analysis for disease-free and overall survival
Disease-free survivalOverall survival
UnivariateP valueMultivariate (HR, 95%CI)P valueUnivariateP valueMultivariate (HR, 95%CI)P value

Age0.45Age0.35
Sex0.0510.59Sex< 0.00110.13
Albumin0.27Albumin0.28
ECOG status0.38ECOG status0.00610.15
Pre-op CEA0.39Pre-op CEA0.070.51
Grade< 0.00111.8 (1.2-2.8)0.0081Grade< 0.00112.80 (1.26-6.21)0.011
Signet ring cell< 0.00110.828Signet ring cell< 0.00110.22
Lympho-vascular invasion< 0.00110.15Lympho-vascular invasion< 0.00110.82
Lymph node metastasis< 0.00110.42 (0.20-0.88)0.021Lymph node metastasis< 0.00110.47
PSS0.091.3 (1.1-1.6)0.031PSS0.14
PCI0.0311.05 (1.02-1.08)0.0021PCI< 0.0011.10 (1.03-1.16)0.0021
CC0 resection< 0.00110.32 (0.11-0.92)0.03
Table 3 Illustrates the incidence of lymph node metastasis as stratified by histological grade, and the presence or absence of signet ring cells
Incidence of lymph node metastasis
Histological gradeP < 0.001
Well-differentiated5.50%
Moderately-differentiated10.80%
Poorly-differentiated42.10%
Signet ring cellP = 0.08
Absent7.50%
Present20.80%
Moderately-differentiated and LVI-6%P = 0.008
Moderately-differentiated and LVI+40%