Oncologists’ perceptions of evidence and standardization in appendiceal cancer management: A national survey.

Abstract

820 Background: Appendiceal cancers (AC) are rare, histologically diverse malignancies for which evidence-based treatment guidelines are limited, and treatment decisions are often extrapolated from colorectal cancer protocols or based on expert consensus. While prior studies have described oncologists’ practice patterns, little is known about oncologists’ perceptions of the sufficiency of evidence, standardization of guidelines, and the availability of educational resources for AC. Understanding these perceptions is critical to guiding future research and standardization efforts. Methods: We conducted a national cross-sectional survey of gastrointestinal oncologists (N=114) between April - October 2023 to assess current provider perceptions regarding AC management. Survey items focused on patient volume, provider confidence, perceived standardization of treatment, and perceived quality of educational resources. Responses were summarized descriptively to quantify perceived gaps and barriers in AC management. Results: Among 114 respondents, 82.5% reported that current data and studies are insufficient to support evidence-based guidelines and standardized systemic therapy for AC. 68% perceived treatment as “not standardized” or only “somewhat standardized.” Guideline use was heterogeneous: 84% reported using NCCN guidelines, 27% used surgical society guidelines, and 18% used other guidelines including Chicago Consensus Guidelines, ENETS, NANETS, MDACC practice patterns, and UpToDate (multiple responses allowed). Regarding educational resources, 41% of respondents rated them as “poor” or “very poor”, 46% rated them as “fair”, and 13% rated them as “good” or “excellent”. Conclusions: This national survey highlights that GI oncologists perceive substantial gaps in evidence, standardization, and education for AC management. Unlike prior studies focused on practice patterns, these results quantify provider perceptions regarding the adequacy of current guidelines for AC. These findings underscore the need for prospective multicenter trials to generate higher quality evidence, consensus guideline development, and targeted educational initiatives to reduce variability and improve outcomes for patients with AC. GI oncologists’ perceived sufficiency of evidence for systemic therapy guidelines for appendiceal cancer. Do you think there are sufficient data and studies to support evidence-based guidelines and standardization of systemic therapies for appendiceal cancers? Frequency Valid Percent Yes, definitely 4 3.5 Probably 16 14.0 Probably not 57 50.0 No, definitely not 37 32.5 Total Valid 114 100.0