Survival Outcomes Used to Validate Version 9 of the American Joint Committee on Cancer Staging System for Appendiceal Cancer

Authors

Lauren M Janczewski
Amanda E Browner
Joseph H Cotler
Heidi Nelson
Sanjay Kakar
Norman J Carr
Nader N Hanna
Andreana N Holowatyj
Richard M Goldberg
M Kay Washington
Elliot A Asare
Michael J Overman
American Joint Committee on Cancer Expert Panel on Cancers for the Lower Gastrointestinal Appendix Disease Site

Publication Date

1-1-2023

Journal

CA: A Cancer Journal for Clinicians

DOI

10.3322/caac.21806

PMID

37358310

PMCID

PMC11954078

PubMedCentral® Posted Date

3-29-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

The standard for cancer staging in the United States for all cancer sites, including primary carcinomas of the appendix, is the American Joint Committee on Cancer (AJCC) staging system. AJCC staging criteria undergo periodic revisions, led by a panel of site-specific experts, to maintain contemporary staging definitions through the evaluation of new evidence. Since its last revision, the AJCC has restructured its processes to include prospectively collected data because large data sets have become increasingly robust and available over time. Thus survival analyses using AJCC eighth edition staging criteria were used to inform stage group revisions in the version 9 AJCC staging system, including appendiceal cancer. Although the current AJCC staging definitions were maintained for appendiceal cancer, incorporating survival analysis into the version 9 staging system provided unique insight into the clinical challenges in staging rare malignancies. This article highlights the critical clinical components of the now published version 9 AJCC staging system for appendix cancer, which (1) justified the separation of three different histologies (non-mucinous, mucinous, signet-ring cell) in terms of prognostic variance, (2) demonstrated the clinical implications and challenges in staging heterogeneous and rare tumors, and (3) emphasized the influence of data limitations on survival analysis for low-grade appendiceal mucinous neoplasms.

Keywords

Humans, United States, Appendiceal Neoplasms, Neoplasm Staging, Prognosis, Survival Analysis, American Joint Committee on Cancer (AJCC) staging, appendiceal cancer, mucinous appendix cancer, non-mucinous appendix cancer, signet-ring cell appendix cancer

Published Open-Access

yes

Recommended Citation

Janczewski, Lauren M; Browner, Amanda E; Cotler, Joseph H; et al., "Survival Outcomes Used to Validate Version 9 of the American Joint Committee on Cancer Staging System for Appendiceal Cancer" (2023). Faculty, Staff and Student Publications. 3705.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/3705