Clinicopathological Features And Prognosis Of Right Colon Cancer With Acute Appendicitis As The First Clinical Feature

Background In recent years,the number of colon cancer patients in China has continued to rise,and it is one of the common malignant tumors in the digestive tract.The anatomy of the right colon cancer,especially the ileocecal tumor,is close to the appendix.The tumor will cause acute appendicitis by direct compression of the appendix cavity,and indirect inflammation and edema can lead to acute appendicitis.These clinical symptoms caused by appendicitis caused by right colon cancer may mislead the clinician’s judgment.In some hospitals in China,there are imbalances in the distribution of medical personnel and medical resources,resulting in partial right colon cancer in clinical work.The patient was first diagnosed with acute appendicitis and treated,which delayed the diagnosis and treatment of these patients with right colon cancer,resulting in poor prognosis.Objective This study was to investigate the clinicopathological features and prognosis of right colon cancer with acute appendicitis as the first clinical feature.Methods This study was a retrospective analysis of patients who underwent radical resection of right colon cancer in Shaanxi Provincial People’s Hospital from October 2012 to October 2015.A total of 582 patients with medical history data.A total of 486 patients who underwent radical resection of right colon cancer were screened according to inclusion and exclusion criteria.Patients were divided into two groups according to whether they had right colon cancer with acute appendicitis as the first clinical feature.The study group included 43 patients with right colon cancer who developed acute appendicitis as the initial clinical feature.The first diagnosis of right colon cancer was 443 patients as a control group.The clinicopathological features of the patients with right colon cancer were compared and the prognosis of the study group was analyzed.Results 1.All 486 patients with right colon cancer were enrolled in this study,including 275 males(56.6%)and 211 females(43.4%).The mean age was(64.77±14.09)years old,and the median survival time was 31(95%,CI).18.62-43.38)month.In the right colon cancer group,43 patients(8.8%)with acute appendicitis as the first clinical feature,and 443 patients(91.2%)with the first diagnosis of right colon cancer.There were significant statistical differences in tumor location,differentiation,and TNM staging(all P<0.05),but not with gender,age,tumor diameter,depth of invasion,and general type(all P>0.05).2.Univariate analysis showed that tumor location,tumor diameter,depth of invasion,gross type,degree of differentiation,and TNM stage were associated with prognosis(all P<0.05).Multivariate analysis showed that tumor location,tumor diameter and TNM staging were independent risk factors for postoperative overall survival in patients with right colon cancer who had the first clinical feature of acute appendicitis.The difference was statistically significant(all P<0.05).TNM staging was an independent risk factor for postoperative tumor-free survival in patients with right colon cancer who presented with acute appendicitis as the first clinical feature(P=0.006).3.The 3-year survival rate of patients with right colon cancer with acute appendicitis as the first clinical feature was 44.2%,and the average survival time was(26.25±1.57)months,which was significantly lower than that of patients with right colon cancer alone.The survival time(31.09±0.39)months,the difference was statistically significant(P=0.000).Conclusions 1.Patients with right colon cancer who are located in the ileocecal area and have a low degree of differentiation are more likely to develop acute appendicitis,and the TNM stage is later.The identification of acute appendicitis and ileocecal tumors needs to be alert to clinicians.2.The prognosis of patients with right colon cancer with acute appendicitis as the first clinical feature is worse than the first diagnosis of patients with right colon cancer.3.Tumor site,tumor diameter and TNM staging are independent risk factors for prognosis in patients with right colon cancer who are the first clinical feature of acute appendicitis.TNM staging is an independent risk factor for the survival of tumor-free survival.