Clinical Characteristics and Survival in Never Smokers With Lung Cancer

Introduction and objectiveTo analyse the frequency, clinical characteristics and survival of patients with lung cancer (LC) who have never smoked in comparison to that in patients who smoke.Patients and methodsA retrospective study in patients diagnosed with LC by cytohistology between 1999 and 2011. Survival was estimated by the Kaplan–Meier method. The χ² test was used to estimate the relationship between the variables.ResultsA total of 2161 patients were diagnosed with LC, 396 (18.3%) of whom had never smoked. The mean age (±standard deviation) in this group was 72.85±10.52 years; 64.6% were women and 35.4% men. According to the cytohistology, 55.6% were adenocarcinoma, 20.5% squamous cell, 15% small cell, 2.7% large cell, and 6.2% other subtypes. The diagnosis was made in advanced stage (iv) in 61.4%, and 14.4% of the patients received surgical treatment. Survival was 12.4%, with no differences between the two groups. In the group of never smokers, women had better survival than men.ConclusionsOf the patients diagnosed with LC, 18.3% had never smoked. It was diagnosed mainly in women, at advanced stages and the most common histological type was adenocarcinoma. There were no survival differences compared to the group of smokers.     

Lung Cancer in Women: a Comparison with Men and an Analysis of Cases Diagnosed in Ourense (Spain) 1999–2006

Introduction and objectiveTo analyse the frequency, characteristics and survival of women with lung cancer (LC), compared with male patients.Patients and methodsA retrospective study was performed in patients with LC diagnosed by histocytology from 1999 to 2006. Survival was estimated by the Kaplan-Meier method. The chi-squared test was used to compare variables.ResultsA total of 1,290 patients were diagnosed; 190 (14.7%) of them were women, with a mean age of 67 ± 13. The percentage of smokers was 17%. Histological types included: adenocarcinoma 53%, small cell 21%, epidermoid carcinoma 13%. Surgery was performed (20%) in a higher percentage of women than in men. There were no differences in survival between the two groups.ConclusionsOf the total cases diagnosed, 14.7% were women, with a lower percentage of smokers. Adenocarcinoma was the most common histological type. There were no differences in survival compared to men.     

Preoperative Body Weight and Albumin Predict Survival in Patients With Resectable Lung Neoplasms: Role of COPD

IntroductionThe impact of preoperative nutritional status on survival in lung cancer (LC) patients with underlying chronic obstructive pulmonary disease (COPD) is still unclear. We hypothesized that presurgical nutritional assessment may differentially predict mortality in patients with resectable LC with moderate COPD and relatively well-preserved nutritional status.MethodsNutritional assessment [body mass index (BMI), blood parameters including albumin and protein levels, and body weight loss], and other clinical parameters [cigarette smoking (CS) history, LC staging and histological subtypes, COPD severity, lung function, and adjuvant therapy] were evaluated in 125 patients from the LC Mar Prospective Cohort: 87 LC-COPD patients and 38 LC patients without COPD before thoracotomy. Ten-year overall survival (OS) was analyzed in all patients.ResultsPrior to thoracotomy, in LC-COPD patients compared to LC, BMI and albumin declined relatively, low levels of the parameters BMI, albumin, and total proteins were associated with poorer 10-year survival, especially in the LC-COPD. CS burden also correlated with impaired survival. COPD per se worsened the prognosis in LC patients.ConclusionsIn the present cohort of LC patients with resectable tumors and relatively well-preserved nutritional status, the parameters BMI and blood albumin and protein levels measured prior to thoracotomy predicted OS, especially in those with COPD. These are clinically relevant findings, since values of those nutritional parameters were within the normal ranges in the majority of the analyzed patients. A thorough nutritional preoperative assessment should be included in the study of patients with resectable LC, particularly in those with chronic airway obstruction.     

Incidence of Carcinoma in the Native Lung After Single Lung Transplantation

BackgroundThis study aims to assess the incidence of primary lung cancer in the native lung and its impact on survival in patients undergoing single lung transplantation (SLT).MethodsThis study retrospectively analyzed 161 SLTs performed between June 2012 and June 2019. The incidence of carcinoma in the native lung and its influence on patient survival was determined. Recipient variables, tumor stage, and survival were analyzed and compared between patients with and without native lung cancer. The analysis was adjusted for transplant indication. Both univariable and multivariable analyses were performed. The present study followed the Declaration of Helsinki Ethical Principles for Medical Research involving human subjects.ResultsThere were 161 patients (126 men/35 women; 57 ± 7 years) transplanted for chronic obstructive pulmonary disease (COPD) (n = 72), idiopathic pulmonary fibrosis (IPF) (n = 77), or other indications (n = 12). Eleven patients with COPD (7%) developed lung cancer in the native lung after SLT. Lung cancer did not appear in any of the SLTs for pulmonary fibrosis. Five participants were in stages I/II and underwent lung resection, and 6 participants were in stages III/IV and underwent chemotherapy/radiotherapy. Survival (1, 3, and 5 years) without vs with native lung carcinoma in patients with COPD was 89%, 86%, and 80% vs 86%, 71%, and 51% (P = .04). The occurrence of carcinoma in the native lung predicted survival in patients with COPD (odds ratio [OR]: 2.55; P = .07).ConclusionsLung cancer in the native lung is a frequent and devastating complication after SLT in patients with COPD, which might negatively affect long-term survival. This should be considered when choosing the transplant procedure for patients with COPD.     

Clinical features of lung cancer in smokers with light and mild chronic obstructive pulmonary disease: a retrospective analysis of Japanese surgical cases

Objectives: We estimated the influence of chronic obstructive pulmonary disease (COPD) upon the clinicopathological characteristics of lung cancer (LC) in Japanese surgical cases by comparing LC cases in non-COPD smokers. Method: A consecutive cohort comprising 157 COPD patients (78 in Global Initiative for Obstructive Lung Disease-1 (GOLD-1) and 79 in GOLD-2) and 374 non-COPD smoker-LC patients were enrolled in this study. Comparative analyses of the clinicopathological features of these two groups, including clinical outcomes, were performed. Results: By analyzing all cases, we found that LC patients with COPD were older on average, more likely to be male, and heavier smokers than LC patients without COPD. In sub-analysis involving matched patient backgrounds, histological differentiation grade of LC in smokers with COPD was lower than in LC smokers without COPD, although distribution of clinical stages and histological types of LCs did not differ between smokers with and without COPD. The 5-year-survival rate in COPD patients was poorer than in non-COPD smokers in terms of both overall (38% vs 54%) and cancer-related mortality (45% vs 63%). By single-variant risk analysis, COPD became a prognostic factor. Conclusion: We concluded from our analysis that COPD-related LC may have a higher malignant potential than LC in non-COPD smokers, as the histological differentiation grade and clinical outcomes were poorer.     

Commentary on “Racial disparity in renal cell carcinoma patient survival according to demographic and clinical characteristics.” Chow WH,Shuch B,Linehan WM,Devesa SS,Division of Cancer Epidemiology and Genetics,National Cancer Institute,Bethesda, MD.: Cancer 2013; 119(2):388–94. [Epub 2012 Nov 12]. doi: 10.1002/cncr.27690.

BackgroundPatients with renal cell carcinoma (RCC) who are black tend to have poorer prognosis than similar patients who are white. This study examined whether the racial disparity in RCC patient survival varies by demographic and clinical characteristics.MethodsNearly 40,000 patients (4359 black and 34,991 white) diagnosed with invasive RCC from 1992 to 2007 were identified from 12 registries in the National Cancer Institute Surveillance, Epidemiology, and End Results program, covering approximately 14% of the US population. Relative survival rates through 2008 were computed using the actuarial method.ResultsProportionally more blacks than whites were diagnosed with RCC under age 50 and with localized cancer. Overall, the 5-year relative survival rates were 72.6% (95% confidence interval 72.0%-73.2%) for white and 68.0% (66.2%-69.8%) for black patients. Survival was higher among women than men and among younger than older patients. Survival decreased with advancing tumor stage and, within each stage, decreased with increasing tumor size. Patients with clear cell RCC, a more common form among whites, had poorer prognosis than patients with papillary or chromophobe subtypes, which are more common among blacks. Survival for patients who received no surgical treatment (10.5% of white patients and 14.5% of black patients) was substantially lower than for patients treated with nephrectomy, with similar survival among whites and blacks. In all other demographic and clinical subgroups of patients, whites consistently had a survival advantage over blacks.ConclusionsPatients with RCC who are white consistently have a survival advantage over those RCC patients who are black, regardless of age, sex, tumor stage or size, histological subtype, or surgical treatment.     

Medullary carcinoma of the thyroid: Prognostic factors and treatment recommendations

Background: Because medullary thyroid carcinoma accounts for only 7% of all thyroid malignancies, data to support treatment strategies are scarce. Methods: We retrospectively reviewed treatment and outcome in 34 patients with MTC treated at Roswell Park between 1961 and 1995. Univariate analysis was performed using the variables age, sex, tumor size, N stage, and M stage. Results: Median survival was 4.7 years, with 51% and 32% of patients alive at 5 and 15 years, respectively. Nodal metastases were seen in 76% and distant metastases in 67% of all patients. More than 60% of the patients with nodal metastases survived longer than 10 years. Once diagnosed with distant metastases, 90% of the patients died within 5 years. Local failure rate with lobectomy was 44%, compared to 10% after total thyroidectomy (P<.02). Age, extrathyroid extension, and M stage portend a poor outcome. Nodal status had no statistically significant impact on survival. Conclusion: Survival with tumors confined to the thyroid gland is independent of nodal status. Long-term survival in patients with distant metastases is rare. This study underscores the role of total thyroidectomy in the initial treatment and the need to develop effective adjuvant therapy for MTC.Presented at the 50th Annual Cancer Symposium of The Society of Surgical Oncology, Chicago, Illinois, March 20–23, 1997.     

Outcomes of complete metastasectomy in metastatic renal cell carcinoma patients: The Canadian Kidney Cancer information system experience

BackgroundSurgical resection of metastasis can be integrated in the management of metastatic renal cell carcinoma (mRCC) as it can contribute to delay disease progression and improve survival.ObjectiveThis study assessed the impact of complete metastasectomy in mRCC patients using real-world pan-Canadian data.Design, Setting and ParticipantsThe Canadian Kidney Cancer information system (CKCis) database was used to select patients who were diagnosed with mRCC between January 2011 and April 2019. To minimize selection bias, each patient having received a complete metastasectomy was matched with up to 4 patients not treated with metastasectomy.Outcome measurements and Statistical AnalysisOverall survival (OS) was calculated from the date of metastasectomy or selection, to death from any cause. A Cox proportional hazards model was used to assess the impact of the metastasectomy while adjusting for potential confounding variables.ResultsA total of 229 patients undergoing complete metastasectomy were matched with 803 patients not treated with metastasectomy. After matching, baseline characteristics were well balanced between groups. After 12 months, the proportion of patients that were still alive was 96.0% and 89.8% in the complete metastasectomy and its matched group, respectively; the 5-year OS were 63.2% and 51.4%, respectively. Multivariate analysis performed in the matched cohort revealed that patients who underwent complete metastasectomy had a lower risk of mortality compared to patients who did not undergo metastasectomy (hazard ratio: 0.41, 95% confidence interval:0.27–0.63).ConclusionOur study found that patients who underwent complete metastasectomy have a longer overall survival and a longer time to initiation of targeted therapy compared to patients not receiving metastasectomy. These findings should support aggressive resection of metastasis in selected patients.     

Prognostic impact of metastasectomy in renal cell carcinoma in the postcytokine therapy era

ObjectivesTo explore the real-world data regarding survival following metastasectomy (MS) for renal cell carcinoma (RCC) in the postcytokine therapy era.Patients and MethodsPatients diagnosed with metastatic renal cell carcinoma (mRCC) between January 2008 and December 2018 at our institutions were retrospectively evaluated. The patients were classified into three groups according to their MS status: (1) complete MS (cMS), (2) incomplete MS (icMS), and (3) without MS (nonMS). Factors for overall survival (OS) after diagnosis were analyzed.ResultsOverall, 314 patients were evaluated. During the follow-up period (median: 25.3 months), a total of 98 patients (31.2%) underwent at least one MS. The cMS group (n = 45, 14.3%) had a significantly longer OS (median: not reached [N.R.]) than the icMS (n = 53, 16.9%) (81.5 months, P= 0.0042) and nonMS groups (28.1 months, P< 0.0001). The icMS group had a significantly longer OS than the nonMS group did (P= 0.0010). Multivariate analysis showed that the MS status was an independent factor for OS (cMS vs. nonMS: P= 0.0004; icMS vs. nonMS: P= 0.0176), together with histopathological type, International Metastatic Renal Cell Carcinoma Database Consortium risk, liver metastasis status, and prior nephrectomy status (all, P< 0.05). In addition, the OS was comparable throughout the eras of systemic therapy (early molecular-targeted therapy, late molecular-targeted therapy, and immune checkpoint inhibitor eras) in the MS group (median: 121.9 vs. N.R. vs. N.R. months, P= 0.948).ConclusionsMS, especially cMS improved survival in selected patients with mRCC in the postcytokine therapy era. In addition, MS still plays a significant role in the current systemic therapy.     

Contemporary trends in management of stage 1 seminoma

PurposeSurveillance is now the preferred treatment strategy for patients with stage 1A/1B seminoma as reflected by the National Comprehensive Cancer Network guidelines. In this study, we aimed to describe trends in adjuvant management strategy for stage 1A/B seminoma from 2004 to 2016 using the National Cancer Database.Materials and methodsThe database was queried for patients diagnosed with stage 1A/1B seminoma between 2004 and 2016. Staging was determined using the American Joint Committee on Cancer guidelines. Surveillance was defined as no treatment with chemotherapy or radiation within 60 days of diagnosis. Proportions of cancer patients utilizing surveillance, radiation, and single-agent chemotherapy were summarized annually. Kaplan-Meier survival analysis was used to compare overall survival between groups.Results8,686 patients with stage 1A/1B seminoma met inclusion criteria over the course of the study period. Overall, 3,004 (34.6%) patients began adjuvant chemotherapy or radiation within 60 days. Utilization of surveillance increased from 39.8% in 2004 to 86.8% in 2016 while utilization of radiation decreased from 59.7% to 4.6%. High-volume centers adopted surveillance earlier than low-volume centers.ConclusionThis study describes trends in utilization of surveillance, chemotherapy, and radiotherapy for stage 1A/1B seminoma over 12 years. A major shift from utilization of adjuvant treatment to surveillance in patients with stage 1A/B seminoma is observed in this large national cancer database; a minority of patients now receive adjuvant treatment and risk-related toxicities. Survival analysis reveals similar survival at a median 5-year follow-up. The results provide insight into the time needed for clinical practice to adopt the preferred approach of surveillance over the time period studied.     

Commentary on “The clinical epidemiology of urachal carcinoma: Results of a large,population based study.” Bruins HM,Visser O,Ploeg M,Hulsbergen-van de Kaa CA,Kiemeney LA,Witjes JA,Department of Urology,Radboud University Medical Centre,Utrecht, The Netherlands: J Urol 2012;188(4):1102–7 [Epub 2012 Aug 15]

PurposeSurvival data on urachal carcinoma are sparse due to the low prevalence of this cancer. We report urachal carcinoma clinical outcomes and prognostic factors in a large, population based cohort of patients with long-term followup.Materials and MethodsData were collected from the nationwide Netherlands Cancer Registry. Urachal carcinoma cases were also cross-referenced using the PALGA (Nationwide Network and Registry of Histology and Cytopathology) database. Pathology report summaries were reviewed. A total of 152 patients diagnosed with urachal carcinoma between 1989 and 2009 were included in analysis. The Sheldon staging system was used to classify urachal carcinoma. Median followup was 9.2 years. Primary outcomes were overall and relative survival. Prognostic factors were calculated using univariate and multivariate hazard regression models.ResultsThe incidence of urachal carcinoma was 0.2% of all bladder cancers. A total of 45 patients (30%) presented with lymph node or distant metastasis. Five-year overall and relative survival was 45% and 48%, respectively. On multivariate analysis prognostic factors for impaired survival were lymph node metastasis (HR 1.7, 95% CI 1.2–2.6), tumor growth in the abdominal wall, peritoneum and/or adjacent organs (HR 5.2, 95% CI 2.6–10.3), distant metastasis (HR 5.3, 95% CI 2.8–9.9) and macroscopic residual tumor (HR 5.2, 95% CI 1.2–21.8).ConclusionsUrachal carcinoma is rare, accounting for 0.2% of all bladder cancers. Many patients present with advanced disease. The prognosis of urachal carcinoma depends mostly on tumor stage, particularly the presence or absence of metastatic disease.     

Prognostic value of carcinoembryonic antigen and carbohydrate antigen 19–9 in periampullary cancer patients receiving pancreaticoduodenectomy

BackgroundWe assessed the use of serum concentrations of carbohydrate antigen (CA) 19–9 and carcinoembryonic antigen (CEA) measured during the preoperative diagnostic workup as prognostic factors for survival in patients with periampullary carcinoma.MethodsA retrospective review of patients diagnosed with periampullary carcinoma who underwent radical surgery was conducted. Factors related to the survival of periampullary carcinoma patients, including CA 19–9 and CEA, were analyzed.ResultsThe mean age of the 112 patients included in the results was 66.41 ± 10.513 years. In the study, the percentage of patients with elevated serum CA 19–9 and CEA concentrations was 65.2% and 24.1%, respectively. CA 19–9 concentrations were correlated with the tumor stage, pre-operative jaundice, and lymphovascular invasion, but CEA concentrations were not. The median overall survival was longer for the normal serum CA 19-9 group than the group with increased CA 19–9 (56 months vs. 25 months, p = 0.003); however, there was no statistically significant difference between the normal serum CEA group and the group with increased CEA (43 months vs. 25 months, p = 0.077). Independent factors related to overall survival were sex, age, stage, presence of jaundice, lymphovascular invasion, perineural invasion, margin status, and elevated serum CA 19–9 concentrations.ConclusionsPeriampullary carcinoma patients with elevated serum CA 19–9 concentrations at diagnosis are expected to have poor overall survival. CA 19–9 may be a useful marker for predicting prognosis in patients with periampullary carcinoma at the time of diagnosis.     

Surgery for Unusual Histopathologic Variants of Esophageal Neoplasms: A Report of 23 Cases With Emphasis on Histopathologic Characteristics

Background: Adenocarcinoma and squamous cell carcinoma are the most frequent pathologic diagnoses with esophageal malignancy. Unusual pathologic variants are encountered in only 1% to 7% of patients, and therefore data evaluating the treatment and survival in this group of esophageal neoplasms are sparse.Methods: To get more insight into the unusual pathologic variants, patients were selected from our computer-assisted database containing data from 426 consecutive patients treated with esophageal resection or enucleation at our institute during 1993 to 2000.Results: Uncommon variants of esophageal neoplasms were encountered in 23 patients (5.3%). The following unusual histopathologic variants were seen: basaloid squamous cell carcinoma (n = 3), small-cell carcinoma (n = 1), leiomyoma (n = 5), gastrointestinal stromal tumor (n = 2), leiomyosarcoma (n = 1), adenosquamous carcinoma (n = 5), carcinosarcoma (n = 4), collision tumor (n = 1), and melanoma (n = 1). Presentation, histopathologic characteristics, treatment, and prognosis are described in reference to the existing literature.Conclusions: Survival data of the unusual pathologic variants seem to be comparable to those of the most frequently encountered neoplasms. Only in case of small-cell carcinoma does there seem to be a definite role for chemotherapy, especially in a multimodality treatment protocol.     

Incidental Gallbladder Carcinoma Diagnosed During or After Laparoscopic Cholecystectomy

Background

Gallbladder carcinoma (GC) is a highly lethal neoplasm. With the increase of cholecystectomies since the wide acceptance of laparoscopic cholecystectomy (LC), the incidental diagnosis of gallbladder carcinoma is more frequent. The aim of the present study was to report our experience with GC diagnosed during or after the performance of LC.

Methods

A total of 10,466 LCs were carried out from January 1999 to December 2007 in our hospital. Records of patients with incidental carcinoma were collected and analyzed retrospectively.

Results

Of all the patients, 20 (0.19%) were histopathologically diagnosed as having a GC. There were 4 men and 16 women; the median age in this group was 65.7 years (range: 37–81 years).The depth of cancer invasion was: pTis (4 cases), pT1a (2 cases), pT1b (2 cases), pT2 (6 cases), pT3 (4 cases), and pT4 (2 cases). The sensitivity and specificity of intraoperatively frozen section examination were 83.3 and 100%, respectively. Patients with in situ, pT1a and pT1b tumors underwent LC only, and there were no recurrences. The survival rate between patients with GC diagnosed during or after LC showed no difference; it was dependent on the depth of cancer invasion.

Conclusions

The survival with incidental GC is related to stage, and it validates that a carefully performed LC is adequate treatment for carcinoma in situ, and stage 1a and b cancer. A frozen section examination was helpful but did not provide a definitive diagnosis. Meticulous techniques during LC, including retrieval of the gallbladder in a retrieval bag, may prevent port-site recurrence and intraperitoneal dissemination.     

Survival Analysis of Resection of Lung Metastases From Colorectal Cancer

IntroductionThe publication of the International Registry of Lung Metastases (IRLM) in 1997 was a turning point in favor of surgical resection of lung metastases. Prognostic groups were defined according to resectability, number of metastases, and disease-free interval. The objective of this study was to determine survival in patients who underwent resection of lung metastases from colorectal carcinoma and to evaluate how applicable the prognostic factors established by the IRLM are in this specific patient group.Patients and MethodsPatients with lung metastases from colorectal carcinoma who underwent resection between January 1, 2000, and November 30, 2006, were retrospectively analyzed. Survival was calculated using the Kaplan-Meier method, with log-rank comparisons between groups.ResultsSurvivals at 1, 3, 5, and 6 years was 92%, 75%, 54%, and 43%, respectively. The main finding was that 3-year survival was better in patients who underwent atypical resection of the metastasis (75%) than those who required lobectomy (55%). There were no significant differences in survival in terms of number of lung metastases resected or disease-free interval.ConclusionsSurvival in patients requiring lobectomy for resection of lung metastases from colorectal carcinoma was worse than in those who underwent atypical resection. The number of metastases and disease-free interval may be questionable prognostic factors in the case of lung metastases from colorectal carcinoma.     

Surgical management of T1/T2 node-negative papillary thyroid cancer with tall cell histology: Is lobectomy enough?

BackgroundThe tall cell variant of papillary thyroid carcinoma has traditionally been treated more aggressively than classic papillary thyroid carcinoma. However, this may not be justified in patients with T1/T2 tall cell variant node-negative tumors.MethodsWe evaluated well-differentiated thyroid cancers treated surgically between 1985 and 2015 at our institution. We compared patients undergoing lobectomy for node-negative T1/T2 tall cell variant tumors with the same cohort with classic papillary thyroid carcinoma. Patients who underwent early planned completion thyroidectomy were excluded. Tall cell variant tumors were defined as those with ≥30% tall cells. Survival and recurrence outcomes were determined by the Kaplan-Meier method and groups compared using the log-rank test.ResultsThyroid lobectomy was performed for T1/T2 N0X disease in 70 (15%) tall cell cases and 429 (23%) classic papillary thyroid carcinoma cases. There was no significant difference in 10-year overall survival (P = .56) or locoregional recurrence-free probability (P = .52). Disease-specific survival and local or central nodal recurrence-free probability were 100% in both groups. In 9 papillary thyroid carcinoma cases, subsequent contralateral lobe tumors developed, and in 5, lateral neck metastases developed. No recurrences were seen in the tall cell group.ConclusionT1 node-negative tumors with tall cell histology can be satisfactorily managed with thyroid lobectomy, with equivalent oncological outcomes to classic papillary thyroid carcinoma.     

Does signet ring cell carcinoma component signify worse outcomes for patients with colorectal cancer?

AimThe purpose of this study was to elucidate the differences in clinical pathology and prognosis between signet ring cell carcinoma component and adenocarcinoma in colorectal cancer.Materials and methodsFrom April 2007 to December 2016, a total of 4348 patients with colorectal cancer underwent surgery, of which 3283 were included in the study. One patient was diagnosed with signet ring cell carcinoma (SRCC); 16 were diagnosed with signet ring cell carcinoma component (SRCCc); and 3266 patients were diagnosed with adenocarcinoma (ADC). We matched SRCCc and ADC with a propensity score of 1:3 and analyzed overall survival rates (OS) and cancer-specific survival rate (CSS) between the 2 groups before and after matching.ResultsBefore matching, patients in the SRCCc group had more advanced cancer (stage III-IV: 87.5% vs 45.6%; P < .001), more perineural invasion (75.0% vs 44.2%; P = .013), and higher lymphatic invasion (87.5% vs 42.4%; P < .001) than those in the ADC group. Consequently, the OS (P < .001) and CSS (P = .049) of the SRCCc group were worse than the ADC group. Peritoneal metastasis was found in 4 (57%) patients with stage IV disease. However, after tumor staging and all background factors were matched, there were no significant differences in prognosis for OS (P = .127) and CSS (P = .932) between the 2 groups.ConclusionSRCCc is more likely to be associated with lymphatic invasion and perineural infiltration than ADC, leading to significantly poorer survival outcomes. However, when all background factors are matched with ADC, the prognosis of SRCCc is not worse than ADC. Improving the treatment outcomes of peritoneal metastasis may be pivotal in the treatment of SRCCc.