Appendiceal Mucinous Neoplasms: Diagnosis and Management

Shaib, Walid Labib; Assi, Rita; Shamseddine, Ali; Alese, Olatunji B.; Staley, Charles; Memiş, Bahar; Adsay, Volkan; Bekaii‐Saab, Tanios; El‐Rayes, Bassel F.

doi:10.1634/theoncologist.2017-0081erratum

Cited by 50 publications

(82 citation statements)

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“…These results support the continued use of surgical debulking in patients with metastatic low‐grade mucinous appendiceal adenocarcinoma. This is also in accord with prior studies which have shown that one of the most important predictors of survival is completeness of cytoreduction …”

Section: Discussionsupporting

confidence: 91%

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Systemic chemotherapy and survival in patients with metastatic low‐grade appendiceal mucinous adenocarcinoma

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Meyerhardt

et al. 2019

Journal of Surgical Oncology

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Background Appendiceal cancer is a rare malignancy that exhibits a wide range of histology and treatment response. Given the rarity and heterogeneous nature of the disease, it has been difficult to define optimal treatment strategies. Our goal is to examine the association between use of systemic chemotherapy and survival in patients with metastatic low‐grade mucinous appendiceal adenocarcinoma. Methods The National Cancer Database (2004‐2015) was queried, and patients with mucinous, grade 1, stage IV appendiceal adenocarcinoma were identified. The Kaplan‐Meier method was used to calculate survival, and a Cox regression model was used to identify predictors of survival. Results Six hundred and thirty‐nine patients were identified. Five‐year overall survival (OS) for patients undergoing no chemotherapy vs chemotherapy was 52.9% and 61.3%, respectively. After adjusting with Cox proportional hazards model, chemotherapy was not associated with OS (HR:1.1, 95% CI:0.82‐1.40, P = 0.61). Patients who underwent surgical resection (HR:0.40, 95% CI:0.28‐0.57, P < .001) or were female (HR:0.61, 95% CI:0.5‐0.8, P < .001) had improved survival in adjusted analysis. Conclusions There is no association between undergoing chemotherapy and OS in this cohort of patients with stage IV low‐grade mucinous appendiceal adenocarcinoma. Development of national treatment guidelines is urgently needed for more consistency in the management of patients with appendiceal cancers.

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Section: Discussionsupporting

confidence: 91%

“…This is also in accord with prior studies which have shown that one of the most important predictors of survival is completeness of cytoreduction. 7 This study has limitations that must be considered when interpreting our results. The NCDB does not have specific codes for cytoreduction or debulking.…”

Section: Discussionmentioning

confidence: 99%

Systemic chemotherapy and survival in patients with metastatic low‐grade appendiceal mucinous adenocarcinoma

Fields

Meyerhardt

et al. 2019

Journal of Surgical Oncology

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“…While the age range of acute appendicitis in adults tends to peak between 20 and 40 years of age, 1 the median age of diagnosis for appendiceal cancer is reported to be late 50s to early 60s. 2 However, recent studies have demonstrated that the rates of appendiceal cancer have not only increased over time but that the age of diagnosis has significantly decreased as well. 3 Therefore, while cancer risk may be lower in those under age 50 relative to an older population, there is still risk of appendiceal cancer and we must be vigilant and fully discuss risks and benefits of nonoperative management with these patients.…”

Section: Shared Decision-making and Nonoperative Management Of Appendmentioning

confidence: 99%

“…One comment is focused on the applicability of the information that patients aged greater than 50 are at increased risk of appendiceal cancer in the context of the known incidence pattern of acute appendicitis. While the age range of acute appendicitis in adults tends to peak between 20 and 40 years of age, the median age of diagnosis for appendiceal cancer is reported to be late 50s to early 60s . However, recent studies have demonstrated that the rates of appendiceal cancer have not only increased over time but that the age of diagnosis has significantly decreased as well .…”

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confidence: 99%

Shared decision‐making and nonoperative management of appendicitis

McCarty

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2019

Journal of Surgical Oncology

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“…Histological examination revealed a low‐grade, well‐differentiated, mucinous cystadenocarcinoma with serosal and angiovascular invasion, which invaded the mesoappendix (T4aNx) .…”

mentioning

confidence: 99%