Du R, Xiao JW. Prognostic impact of number of examined lymph nodes on survival of patients with appendiceal neuroendocrine tumors. World J Clin Cases 2022; 10(30): 10906-10920 [PMID: 36338239 DOI: 10.12998/wjcc.v10.i30.10906]
Corresponding Author of This Article
Jiang-Wei Xiao, MD, PhD, Professor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chengdu Medical College, No. 278 Baoguang Avenue, Xindu District, Chengdu 610500, Sichuan Province, China. xiaojiangwei2018@163.com
Research Domain of This Article
Research & Experimental Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Clin Cases. Oct 26, 2022; 10(30): 10906-10920 Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.10906
Table 1 Demographics and clinicopathologic characteristics
Factor
Category
mean ± SD/n (%)
Age
mean ± SD, yr
44.59 ± 18.15
Year
1975-1980
141 (3.08)
1981-1990
128 (2.79)
1991-2000
274 (5.98)
2001-2010
1163 (25.38)
2011-2016
2877 (62.77)
Race
White
3932 (87.34)
Black
375 (8.33)
Other
195 (4.33)
Sex
Male
1972 (43)
Female
2611 (57)
Grade
Grade 1
1857 (72.59)
Grade 2
408 (15.96)
Grade 3
248 (9.69)
Grade 4
45 (1.76)
Histological type
Large cell neuroendocrine carcinoma
6 (0.13)
Small cell carcinoma
1 (0.02)
Carcinoid tumor
2266 (49.44)
Enterochromaffin cell carcinoid
25 (0.55)
Goblet cell carcinoid
1033 (22.54)
Mixed adenoneuroendocrine carcinoma
366 (7.99)
Adenocarcinoid tumor
417 (9.10)
Neuroendocrine carcinoma
419 (9.14)
Atypical carcinoid tumor
50 (1.09)
Tumor size
mean ± SD, mm
17.56 ± 19.69
Stage
I
1220 (57.36)
II
504 (23.70)
III
270 (12.69)
IV
133 (6.25)
T stage
Tx
86 (3.86)
Tis
7 (0.31)
T1
1290 (57.87)
T2
194 (8.70)
T3
446 (20.01)
T4
204 (9.15)
M stage
M0
2094 (94.07)
M1
132 (5.93)
N stage
N0
2551 (81.76)
N1
569 (18.24)
Surgery
Local resection
405 (10.34)
Colectomy or greater
3513 (89.66)
ELNs
mean ± SD
16.54 ± 10.81
LNR
mean ± SD
0.26 ± 0.28
Survival duration
mean ± SD, mo
64.57 ± 89.96
Table 2 Univariate analysis using Cox proportional hazard model
Factor
Category
HR
95%CI
Log-rank P value
Age
≤ 40 yr
-
-
P < 0.001
41-65 yr
7.25
5.09-10.32
≥ 66 yr
16.14
11.08-23.52
Year
1975-1980
-
-
P < 0.001
1981-1990
3.06
1.56-6.01
1991-2000
4.72
2.51-8.85
2001-2010
3.83
2.09-7.02
2011-2016
1.84
0.98-3.43
Race
White
-
-
P = 0.02
Other
1.15
0.73-1.83
Black
1.58
1.20-2.08
Sex
Male
-
-
P = 0.80
Female
1.02
0.85-1.23
Grade
Grade 1/2
-
-
P < 0.001
Grade 3/4
19.14
13.63-26.87
Histological type
Carcinoid tumor
-
-
P < 0.001
Neuroendocrine carcinoma
2.36
1.44-3.88
Goblet cell carcinoid
4.98
3.61-6.87
Adenocarcinoid tumor
6.87
4.89-9.64
Mixed adenoneuroendocrine carcinoma
14.45
10.30-20.27
Tumor size
≤ 2 cm
-
-
P < 0.001
> 2 cm
8.54
5.99-12.17
Stage
I/II
-
-
P < 0.001
III/IV
17.12
11.78-24.87
T stage
T1
-
-
P < 0.001
T2
5.16
1.29-20.64
T3
17.25
6.09-48.81
T4
117.44
43.03-320.55
M stage
M0
-
-
P < 0.001
M1
31.37
22.16-44.39
N stage
N0
-
-
P < 0.001
N1
8.44
6.69-10.65
Surgery
Local resection
-
-
P < 0.001
Colectomy or greater
3.47
1.95-6.17
ELNs
≥ 11
-
-
P < 0.001
≤ 10
1.75
1.37-2.23
LNR
0-0.16
-
-
P < 0.001
0.17-0.48
3.23
2.25-4.64
0.49-1
7.70
5.38-11.01
Table 3 The 3-, 5-, and 10-yr cancer-specific survival rates for patients
Patients
3-yr, %
5-yr, %
10-yr, %
Follow-up, mo
Median follow-up, mo
Median survival time, mo
All
91.2
87.5
81.7
0-499
31
-
Stage I
99.7
99.7
-
0-83
23
-
Stage II
98.7
95.5
-
0-83
42
-
Stage III
89.0
82.0
-
0-82
38
-
Stage IV
42.0
25.1
-
0-83
23
30
Table 4 Fourfold contingency table of tumor size and lymph node status
Tumor size
LN status
Total
N0
N1
≤ 2 cm
1516 (94.0)
97 (6.0)
1613 (100)
> 2 cm
357 (60.6)
232 (39.4)
589 (100)
Total
1873 (85.1)
329 (14.9)
2202 (100)
Table 5 The 3-, 5-, and 10-yr cancer-specific survival rates by lymph node status and cutoff points of examined lymph nodes
Patients
ELNs
3-yr, %
5-yr, %
10-yr, %
Follow-up, mo
Median follow-up, mo
Median survival, mo
All
≤ 10
83.2
76.1
67.9
0-306
36
-
≥ 11
90.3
85.5
79.1
0-347
38
-
Node-negative
≤ 6
94.9
86.5
79.3
0-306
28
-
≥ 7
98.1
95.4
90.1
0-326
43
-
Node-positive
≤ 17
60.7
50.0
40.6
0-345
31
60
≥ 18
78.4
71.5
61.4
0-347
35
-
Table 6 The 3-, 5-, and 10-yr cancer-specific survival rates for node-positive patients based on lymph node ratio cutoff points
LNR
3-yr, %
5-yr, %
10-yr, %
Follow-up, mo
Median follow-up, mo
Median survival, mo
ALL
67.3
58.4
48.9
0-347
33
-
0-0.16
88.5
80.8
68.9
0-347
45
-
0.17-0.48
59.7
46.2
37.4
1-345
32
46
0.49-1
24.7
17.7
14.2
0-203
16
18
Citation: Du R, Xiao JW. Prognostic impact of number of examined lymph nodes on survival of patients with appendiceal neuroendocrine tumors. World J Clin Cases 2022; 10(30): 10906-10920