A retrospective cohort study published in the Journal of Gastrointestinal Cancer used National Cancer Database data from 2006 to 2022 to evaluate the survival benefit of intraoperative systemic chemotherapy in patients with clinical stage II–III (T4, N0–2) appendiceal adenocarcinoma who underwent surgical resection. Appendiceal adenocarcinoma is a rare malignancy with a high risk of peritoneal recurrence, especially in locally advanced stages. Intraoperative systemic chemotherapy is standard for metastatic disease, but its role in nonmetastatic stage II–III disease remains controversial. Among 616 patients, 130 (21.1%) received intraoperative systemic chemotherapy.

These patients were more often younger, treated at academic centers, and had mucinous histology. Overall survival was compared using Kaplan-Meier statistics and multivariable Cox proportional hazard models. In unadjusted…