Are the long-term oncologic outcomes different between appendiceal cancer and right-sided colon cancer? - An exact matching analysis of a 10-year institutional cohort

Sep 22, 2026

This retrospective exact-matching study compares clinicopathologic features and long-term oncologic outcomes between appendiceal cancer and right-sided colon cancer. Patients with stage I–III appendiceal, cecal, or ascending colon cancer treated with curative resection from 2010–2020 were analyzed after 1:3:3 matching by age, sex, TNM stage, and adjuvant chemotherapy. Appendiceal cancer showed more T4 tumors, fewer harvested lymph nodes, and lower overall and disease-free survival. Independent poor prognostic factors included age (≥65), perforation, nodal metastasis, and lymphovascular invasion.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

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Purpose

Methods

Study population and patient selection

Results

Conclusion

Introduction

Epidemiology and histologic heterogeneity

Classification and staging considerations

Methods

Study population and patient selection

ORIGINAL ARTICLE pISSN 2288-6575 • e ISSN 2288-6796 [https://doi.org/10.4174/astr.2026.1](https://doi.org/10.4174/astr.2026.1)10.4.246 Annals of Surgical Treatment and Research | Are the long-term oncologic outcomes different between appendiceal cancer and right-sided colon cancer? An exact matching analysis of a 10-year institutional cohort
Gunwoo Lee, Eun Jung Park, SooYoung Oh, Young Il Kim, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang SikYu
Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea | | | --- | --- | | Purpose: Due to its rarity, treatment guidelines for appendiceal cancer have traditionally followed those established for colorectal cancer, despite showing distinct histologic and clinical features. This study aimed to compare the clinicopathologic characteristics and long-term oncologic outcomes of appendiceal cancer with those of right-sided colon cancers.
Methods: We retrospectively reviewed the records of patients with stage I–III appendiceal, cecal, or ascending colon cancer who underwent curative resection between 2010 and 2020 at our center. A 1:3:3 exact matching for age, sex, TNM stage, and adjuvant chemotherapy was performed. Survival outcomes were analyzed using the Kaplan-Meier and Cox regression methods.
Results: Overall, 245 patients with appendiceal cancer (n = 35), ascending colon cancer (n = 105), and cecal cancer (n = 105) were analyzed. Appendiceal cancer exhibited a higher proportion of T4 tumors and fewer harvested lymph nodes compared with ascending or cecal cancers. The mean follow-up duration was 9.5 years. The 5-and 10-year overall survival rates were lower in appendiceal cancer (66 .2% and 52.9%) than in ascending (91 .2% and 78.4%) or cecal cancer (88 .5% and 78.3%) . Similarly, the 10-year disease-free survival rate was lower in appendiceal cancer (59 .2%) compared with ascending (83 . 1%) and cecal cancers (78 .4%) . Cox regression analysis identified age ( ≥65 years), perforation, nodal metastasis, and lymphovascular invasion as independent predictors of poor prognosis.
Conclusion: Appendiceal cancer exhibited significantly worse long-term survival compared to cecal or ascending colon cancer. Tumor perforation, nodal metastasis, and lymphovascular invasion were adverse prognostic factors for overall and disease-free survival.
[Ann Surg Treat Res 2026 ; 110(4):246-258]
Key Words: Appendiceal neoplasms, Colorectal neoplasms, Survival analysis, Treatment outcome, Prognostic factors | | | INTRODUCTION
Appendiceal cancer is a rare malignancy, accounting for less than 1% of all gastrointestinal tumors, with an estimated annual incidence of approximately 0.1 to 1.3 per 100,000 | individuals [1,2]. In recent decades, its incidence has gradually increased [3], likely due to advances in diagnostic imaging and the frequent incidental discovery of tumors during appendectomy [4,5] . Histologically, appendiceal neoplasms demonstrate marked heterogeneity, encompassing colonic- | Received October 15, 2025, Revised December 12, 2025, Accepted December 23, 2025 Corresponding Author: Eun Jung Park Division of Colon and Rectal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3184, Fax: +82-2-3101-6701 E-mail: [kendoej@naver.com](kendoej@naver.com) ORCID: [https://orcid.org/0000-0002-4559-2690](https://orcid.org/0000-0002-4559-2690) •This study was presented as an oral presentation at the Korean Society of Coloproctology (KSCP) 2025 Congress in Gwangju, Korea. Copyright 2026, the Korean Surgical Society cc Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution NonCommercial License ( [http://creativecommons.org/licenses/by-nc

FAQs

What was the purpose of the study?

To compare clinicopathologic characteristics and long-term oncologic outcomes of appendiceal cancer versus right-sided colon cancers.

How were patients compared between groups?

Records from patients with stage I–III appendiceal, cecal, or ascending colon cancer undergoing curative resection (2010–2020) were retrospectively reviewed, using 1:3:3 exact matching by age, sex, TNM stage, and adjuvant chemotherapy.

Which factors were identified as independent predictors of poor prognosis?

Age (≥65 years), perforation, nodal metastasis, and lymphovascular invasion were independent predictors of poor prognosis.

Sep 22, 2026

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