{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T15:04:17Z","timestamp":1761491057804},"reference-count":11,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,8,30]],"date-time":"2020-08-30T00:00:00Z","timestamp":1598745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The current standard of care for clinically node\u2010negative carcinoid tumours of the appendix &lt;\u00a02.0\u00a0cm in size is appendectomy alone. The aim of this analysis was to evaluate the prevalence of pathological nodal positivity in clinically node\u2010negative appendiceal tumour specimens &lt;\u00a02.0\u00a0cm and quantify the impact of occult pathological nodal positivity on overall survival following resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective database review of the 2019 US National Cancer Database for appendiceal cancer identified 2007 cases of clinically node\u2010negative appendiceal carcinoid tumours based on SEER histology codes 8240, 8241, 8242, 8243, 8243, 8244, 8245, 8246 and 8249. Kaplan\u2013Meier with log\u2010rank testing and multivariate Cox regression analysis evaluated the impact of occult nodal positivity on overall survival following resection for clinically node\u2010negative appendiceal carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of occult nodal positivity increased from 1.9% for sub\u2010centimetre tumours to 7% for tumours between 1.0 and 1.5\u00a0cm, 16.5% for tumours between 1.5 and 2.0\u00a0cm and to &gt;29.5% for tumours &gt;\u00a02.0\u00a0cm. Rates of metastatic spread were similar for tumours &lt;\u00a02.0\u00a0cm but increased for larger tumours. Over two\u2010thirds of patients received a segmental colectomy as definitive surgical therapy. After controlling for differences in cohorts, multivariate analysis showed an increased hazard ratio for mortality of 162% (HR 2.62, CI 1.884\u20133.541) for patients with pathological node\u2010positive disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinically node\u2010negative carcinoid tumours of the appendix bigger than 1.5\u00a0cm have an increased rate of occult nodal spread which has a negative impact on overall survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15287","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T04:06:19Z","timestamp":1596168379000},"page":"1958-1964","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Elevated prevalence of nodal positivity in carcinoid tumours of the appendix smaller than 2\u00a0cm has a negative impact on overall survival"],"prefix":"10.1111","volume":"22","author":[{"given":"M.","family":"Skancke","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Florida Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. P.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Florida Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. J.","family":"Maron","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Florida Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. D.","family":"Wexner","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Cleveland Clinic Florida Weston Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236899"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00422.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198712313172704"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e31828e34a4"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000443165"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181ebb2a5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20179"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.21888"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.01.005"},{"key":"e_1_2_11_11_1","first-page":"1","article-title":"A predictive model for nodal metastases in patients with appendiceal cancers","author":"Day RW","year":"2019","journal-title":"Ann Surg"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.02.050"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.15287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15287","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T16:44:54Z","timestamp":1693327494000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,30]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/codi.15287"],"URL":"https:\/\/doi.org\/10.1111\/codi.15287","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,30]]},"assertion":[{"value":"2020-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}