Propensity adjusted appraisal of the surgical strategy for appendiceal carcinoids
| Autor: | Stefano Necozione, Andrea Ciarrocchi, Gianfranco Amicucci, R. Pietroletti, Francesco Carlei |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Appendiceal cancer Carcinoid tumors Carcinoid Tumor Carcinoid Neuroendocrine tumor Aged Algorithms Appendectomy Appendiceal Neoplasms Colectomy Female Humans Logistic Models Middle Aged Neoplasm Staging Propensity Score Proportional Hazards Models Retrospective Studies Survival Analysis Treatment Outcome Gastroenterology Surgery Medicine (all) Logistic regression Statistical significance medicine Stage (cooking) Proportional hazards model business.industry General surgery medicine.disease Colorectal surgery Propensity score matching business Abdominal surgery |
| Zdroj: | Europe PubMed Central |
| Popis: | The treatment algorithm for appendiceal carcinoids is based on tumor size. We wanted to verify whether right hemicolectomy confers a survival advantage compared with appendectomy in patients with tumors larger than 2 cm. Data regarding patients with primary carcinoid tumors of the appendix were collected from the Surveillance, Epidemiology, and End Results program database. A propensity score with respect to surgical intervention was calculated with a binary logistic regression including gender, stage of disease, and age as covariates. The groups were matched with a 1:1 ratio, using the nearest neighbor algorithm. A Cox proportional hazards model adjusted for propensity score was implemented to assess the impact of surgical intervention on overall survival. Only stage of disease differed between the groups (p = 0.011). After matching, based on the propensity score, our series was constituted of 109 patients undergoing appendectomy and 109 undergoing right hemicolectomy. The type of surgical intervention failed to reach statistical significance. Right hemicolectomy did not seem to confer any survival advantage on patients with appendiceal carcinoids with a diameter >2 cm. For this reason, tumor size should not be considered an absolute indication for right hemicolectomy. |
| Databáze: | OpenAIRE |
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