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Nagesh VK, Aguilar IK, Elias D, Mansour C, Tran HHV, Bhuju R, Sethi T, Sanjeeva PRP, Rivas MG, Martinez E, Auda A, Ahmed N, Philip S, Weissman S, Sotiriadis J, Bangolo A. Factors Affecting Survival Outcomes in Neuroendocrine Tumor of the Appendix over the Past Two Decades. Diseases 2024; 12:96. [PMID: 38785751 PMCID: PMC11120129 DOI: 10.3390/diseases12050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Appendiceal neuroendocrine tumors (NETs) rank as the third most frequent neoplasm affecting the appendix, originating from enterochromaffin cells. This study aims to evaluate the influence of various prognostic factors on the mortality rates of patients diagnosed with NETs of the appendix. METHODS Conducted retrospectively, the study involved 3346 patients, utilizing data sourced from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis centered on investigating demographic characteristics, clinical features, overall mortality (OM), and cancer-specific mortality (CSM) among the cohort. Variables showing a p-value < 0.1 in the univariate Cox regression were incorporated into the multivariate Cox regression analysis. A Hazard Ratio (HR) > 1 indicated an unfavorable prognosis. RESULTS In the multivariate analysis, higher OM and CSM were observed in males, older age groups, tumors with distant metastasis, poorly differentiated tumors, and those who underwent chemotherapy. Non-Hispanic Black individuals showed elevated mortality rates. CONCLUSION Delayed diagnosis may contribute to the increased mortality in this community. Improved access to healthcare and treatment is crucial for addressing these disparities. Larger prospective studies are needed to pinpoint the underlying causes of elevated mortality in non-Hispanic Black populations, and randomized controlled trials (RCTs) are warranted to evaluate therapies for advanced-stage appendix NETs.
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Affiliation(s)
- Vignesh Krishnan Nagesh
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Izage Kianifar Aguilar
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Daniel Elias
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Charlene Mansour
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Hadrian Hoang-Vu Tran
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Ruchi Bhuju
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Tanni Sethi
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Paranjyothy Rao Pirangi Sanjeeva
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Marco Gonzalez Rivas
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Emelyn Martinez
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Auda Auda
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - Nazir Ahmed
- Department of Gastroenterology, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (N.A.); (S.P.); (J.S.)
| | - Shawn Philip
- Department of Gastroenterology, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (N.A.); (S.P.); (J.S.)
| | - Simcha Weissman
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
| | - John Sotiriadis
- Department of Gastroenterology, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (N.A.); (S.P.); (J.S.)
| | - Ayrton Bangolo
- Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA; (I.K.A.); (D.E.); (H.H.-V.T.); (E.M.); (S.W.)
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Mohamed A, Wu S, Hamid M, Mahipal A, Cjakrabarti S, Bajor D, Selfridge JE, Asa SL. Management of Appendix Neuroendocrine Neoplasms: Insights on the Current Guidelines. Cancers (Basel) 2022; 15:295. [PMID: 36612291 PMCID: PMC9818268 DOI: 10.3390/cancers15010295] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/19/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
Appendiceal neuroendocrine neoplasms (ANENs) usually present as incidental findings at the time of appendectomy for acute appendicitis. They are rare, accounting for only 0.5-1% of intestinal neoplasms; they are found in 0.3-0.9% of all appendectomy specimens. They are usually sporadic tumors. There are several histological types including well-differentiated neuroendocrine tumors (NETs), poorly differentiated neuroendocrine carcinomas (NECs), and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs). Histologic differentiation and the grade of well-differentiated NETs correlate with clinical behavior and prognosis. Management varies based on differentiation, aggressiveness, and metastatic potential. There is debate about the optimal surgical management for localized appendiceal NETs that are impacted by many factors including the tumor size, the extent of mesoappendiceal spread, lymphovascular invasion and perineural involvement. In addition, the data to guide therapy in metastatic disease are limited due to the paucity of these tumors. Here, we review the current advances in the management of ANENs within the context of a multidisciplinary approach to these tumors.
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Affiliation(s)
- Amr Mohamed
- Division of Hematology and Medical Oncology, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Sulin Wu
- Department of Internal Medicine, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Medical Genetics, Center for Human Genetics, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Mohamed Hamid
- Department of Stem Cell Biology and Regenerative Medicine, City of Hope Beckman Research Institute, Duarte, CA 91010, USA
| | - Amit Mahipal
- Division of Hematology and Medical Oncology, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Sakti Cjakrabarti
- Division of Hematology and Medical Oncology, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - David Bajor
- Division of Hematology and Medical Oncology, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - J. Eva Selfridge
- Division of Hematology and Medical Oncology, UH Seidman Cancer Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Sylvia L. Asa
- Department of Pathology, UH Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
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