The association between appendectomy and increased invasion of ascending colon cancer: a retrospective study involving 880 patients.

IF 2.5 3区 医学 Q3 ONCOLOGY
Xu Sun, Rui Li, Wen Zhao, Dingchang Li, Guanglong Dong
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Abstract

Background: Ascending colon cancer is a subtype of colorectal cancer (CRC), the most common malignant tumor globally. The appendix has been considered to be a vestigial organ and appendectomy is the most routine management of acute appendicitis. However, limited studies have examined the association between appendectomy and the invasion of ascending colon cancer.

Methods: In this retrospective study, 880 cases of ascending colon cancer were selected. The preoperative and postoperative clinicopathological features were retrospectively studied. Logistic regression was performed and the propensity score matching (PSM) method was used to adjust for confounding factors.

Results: In total of 880 patients, 133 patients had a history of appendectomy. Patients with a history of appendectomy exhibited a higher proportion of number of lymph node metastasis (LNM) (P = 0.047), T4 stage (P = 0.025), N1 stage (P = 0.037), N2 stage (P = 0.045), M1 stage (P = 0.008), stage III (P = 0.047), and stage IV (P = 0.003). The model following PSM revealed that a history of appendectomy was associated with an increased risk of LNM and M1. In 747 patients without a history of appendectomy, 568 patients (76.0%) were diagnosed with chronic appendicitis pathologically. Patients with chronic appendicitis had significantly smaller tumor sizes (P = 0.012), reduced lymphovascular invasion (LVI) (P = 0.001), fewer poorly differentiated tumors (P = 0.012,), a lower number of LNM (P = 0.020), less frequent T4 stage tumors (P = 0.023), and a decreased incidence of N2 stage disease (P = 0.035).

Conclusions: Appendectomy is associated with a higher aggressiveness of subsequent ascending colon cancer, particularly regarding LNM. Chronic appendicitis has been linked to a decrease in tumor invasion of ascending colon cancer.

阑尾切除术与升结肠癌侵袭增加之间的关系:一项涉及880例患者的回顾性研究。
背景:升结肠癌是结直肠癌(CRC)的一种亚型,是全球最常见的恶性肿瘤。阑尾一直被认为是一个退化器官,阑尾切除术是急性阑尾炎最常规的治疗方法。然而,关于阑尾切除术与升结肠癌侵袭之间关系的研究有限。方法:对880例升结肠癌患者进行回顾性研究。回顾性分析术前、术后临床病理特征。采用Logistic回归,并采用倾向评分匹配(PSM)法对混杂因素进行校正。结果:共880例患者,133例患者有阑尾切除术史。有阑尾切除术史的患者淋巴结转移数(LNM) (P = 0.047)、T4期(P = 0.025)、N1期(P = 0.037)、N2期(P = 0.045)、M1期(P = 0.008)、III期(P = 0.047)、IV期(P = 0.003)的比例较高。PSM后的模型显示,阑尾切除术史与LNM和M1的风险增加有关。在747例无阑尾切除史的患者中,568例(76.0%)患者病理诊断为慢性阑尾炎。慢性阑尾炎患者肿瘤体积较小(P = 0.012),淋巴血管侵袭(LVI)减少(P = 0.001),低分化肿瘤较少(P = 0.012), LNM较少(P = 0.020), T4期肿瘤较少(P = 0.023), N2期发病率降低(P = 0.035)。结论:阑尾切除术与后续升结肠癌的高侵袭性相关,特别是对于LNM。慢性阑尾炎与结肠癌肿瘤侵袭的减少有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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