{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:18:49Z","timestamp":1790731129470,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,6,24]],"date-time":"2019-06-24T00:00:00Z","timestamp":1561334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Appendiceal cancer is a rare malignancy that exhibits a wide range of histology and treatment response. Given the rarity and heterogeneous nature of the disease, it has been difficult to define optimal treatment strategies. Our goal is to examine the association between use of systemic chemotherapy and survival in patients with metastatic low\u2010grade mucinous appendiceal adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database (2004\u20102015) was queried, and patients with mucinous, grade 1, stage IV appendiceal adenocarcinoma were identified. The Kaplan\u2010Meier method was used to calculate survival, and a Cox regression model was used to identify predictors of survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six hundred and thirty\u2010nine patients were identified. Five\u2010year overall survival (OS) for patients undergoing no chemotherapy vs chemotherapy was 52.9% and 61.3%, respectively. After adjusting with Cox proportional hazards model, chemotherapy was not associated with OS (HR:1.1, 95% CI:0.82\u20101.40, <jats:italic>P<\/jats:italic>\u2009=\u20090.61). Patients who underwent surgical resection (HR:0.40, 95% CI:0.28\u20100.57, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) or were female (HR:0.61, 95% CI:0.5\u20100.8, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) had improved survival in adjusted analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is no association between undergoing chemotherapy and OS in this cohort of patients with stage IV low\u2010grade mucinous appendiceal adenocarcinoma. Development of national treatment guidelines is urgently needed for more consistency in the management of patients with appendiceal cancers.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25599","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T18:35:52Z","timestamp":1561487752000},"page":"446-451","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Systemic chemotherapy and survival in patients with metastatic low\u2010grade appendiceal mucinous adenocarcinoma"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-3753","authenticated-orcid":false,"given":"Pamela","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"},{"name":"Department of Surgery, Center of Surgery and Public Health, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam C.","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Meyerhardt","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Center Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Davids","sequence":"additional","affiliation":[{"name":"Memorial Medical Center University of Massachusetts  Worcester Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galyna","family":"Shabat","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Bleday","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel E.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garrett M.","family":"Nash","sequence":"additional","affiliation":[{"name":"Department of Surgery Memorial Sloan Kettering Cancer Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelya","family":"Melnitchouk","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts"},{"name":"Department of Surgery, Center of Surgery and Public Health, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,24]]},"reference":[{"key":"e_1_2_7_1_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-009-9337-2"},{"key":"e_1_2_7_1_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-014-2726-7"},{"key":"e_1_2_7_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70179-7"},{"key":"e_1_2_7_1_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10589"},{"key":"e_1_2_7_1_6_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v9.i9.354"},{"key":"e_1_2_7_1_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29744"},{"key":"e_1_2_7_1_8_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2017-0081"},{"key":"e_1_2_7_1_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23547"},{"key":"e_1_2_7_1_10_1","unstructured":"NCCN. 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