Background: Appendix goblet cell carcinoids are known to share histological features of adenocarcinoma and neuroendocrine tumours. Due to their low incidence, quality evidence is lacking for the management of these patients. Methods: We performed a single-centre retrospective study of patients with a confirmed diagnosis of appendiceal goblet cell carcinoid (GCC; 1996-2014). Patients were divided into curative intent (CI) and palliative intent (PI) cohorts. Our primary end point was overall survival (OS). Results: Seventy-four patients were eligible; 76% were treated with CI [surgery only (36%), cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC; 36%), adjuvant chemotherapy (20%) and a combination of CRS and HIPEC followed by adjuvant chemotherapy (9%)], and 23% had advanced-stage disease amenable to palliative treatment (chemotherapy or supportive care) only. Completion right hemicolectomy, performed in 64% of the CI cohort, did not impact on the relapse rate or disease-free survival. FOLFOX chemotherapy was used in both the adjuvant and palliative settings; safety was as expected, and we observed a high rate (60%) of disease control in the palliative cohort. The estimated median OS (all patients), disease-free survival (CI patients) and progression-free survival (PI patients) were 52.1 (95% CI 29.4-90.3), 75.9 (26.6-not reached) and 5.3 (0.6-5.7) months, respectively. Age and stage were independent factors associated with OS in the multivariable analysis. Tang classification showed a trend for impact on OS. No benefit from specific adjuvant approach was identified; however, selection bias for treatment approach was observed. Conclusion: Prospective trials are needed to define optimal approaches in GCC. All GCC patients should be managed by specialized centres due to their esoteric behaviour; we provide management considerations based on our experience and conclusions.

No abstract

Conclusions: Spatial analysis of immune infiltration in the peripheral regions of liver metastases revealed complex patterns that differ between dHGP and non-dHGP. Thus, although dHGP is overall characterized by a more inflamed phenotype, the vast majority of immune infiltrate accumulated in the peripheral fibrotic capsule and don't interact with cancer cells directly. Instead, intratumoural areas of non-dHGP had higher levels of CD4 cells and Tregs. This potentially reflects different mechanisms of interaction between malignant tissue, immune cells and fibrotic cells.

No abstract

e20718 Background: OEC frequency in elderly patients is increasing around the world and it’s expected to continue rising in the future. PPC is an entity with a similar behaviour. OEC is the most common cause of gynaecologic cancer-related death and it’s the fifth leading cause of cancer associated mortality among women; its relative risk is higher among elderly patients. In this study we try to identify clinical factors in elderly OEC and PPC patients in order to improve current medical management and to enhance clinical outcomes. Methods: From January 2007 to December 2011 a total of 53 elderly patients were included (≥65 years old). PPC: 11.3%; OEC: 88.7%. ECOG 0/1/2/3/4: 24.5/34/26.4/7.5/5.7%; 1.9% unknown. Stage at diagnosis: III (52.8%); IV (30.2%). Ca125 was increased in 79.2% of the cases; 64.2% of the patients underwent debulking surgery. The majority of patients (94.4%) received chemotherapy: monotherapy (13.2%) or polychemotherapy (86.8%). Results: Among 38 evaluable patients, partial response was observed in 45.4%, complete response in 27.2%, stable disease in 24.4% and progression in 3%; 18% of patients were retreated with the same schedule (platinum sensitivity) and 26.4% of the patients received more than one line of chemotherapy (range 2-5). Significant differences in overall survival (OS) were observed in multivariate analysis according to performance status (p=0.018). Median OS for all patients was 131 weeks. Conclusions: In our experience, results in elderly patients are comparable to those expected in younger patients. In this population, treatment options must be optimized.