Low-Grade Appendiceal Mucinous Neoplasms: A Single Institution Experience of 64 Cases With Clinical Follow-up and Correlation With the Current (Eighth Edition) AJCC Staging

Wong, Mary; Barrows, Brad; Gangi, Alexandra; Kim, Stacey; Mertens, Richard B.; Dhall, Deepti

doi:10.1177/1066896919883679

Cited by 15 publications

(5 citation statements)

References 14 publications

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“…This conclusion was compatible with other studies. 5,10,18 PLR-H may indicate higher rate of PMP (p = 0.01); however, unfortunately, both NLR-H and PLR-H could not be used as predictors of cellular ascites. Therefore, cautious handling of mucinous appendiceal tumors during surgery is crucial to avoiding perforation.…”

Section: Discussionmentioning

confidence: 98%

“…These patient characteristics and treatment outcomes were compatible to other larger cohort studies. 18,19 However, due to indolence, and low malignancy of LAMN, complete cytoreduction brought lower recurrent rate than other gastrointestinal tract cancers, even in M stage diseases. 5,20 Therefore, we used RFS instead of disease-free survival or progression-free survival in our series.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on low-grade appendiceal mucinous neoplasm: A single tertiary hospital experience

Kuan

Liang

Lin

et al. 2022

Journal of the Chinese Medical Association

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Background: Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disease, which prognostic factors were difficult to evaluate. Inflammation markers, like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), were used as prognosticators for various cancers. This study aimed to investigate the prognostic value of pretreatment NLR and PLR on LAMN. Methods: From January 2000 to September 2018, there were 57 patients diagnosed with LAMN in Taipei Veterans General Hospital. Patients diagnosed with mucinous cystadenoma, mucinous tumor with uncertain malignant potential before 2010 were also included based on previous classification. Clinical and pathological data were collected. Patients were separated into high-NLR (NLR-H) and low-NLR (NLR-L) groups according to cutoff value of 3. Similarly, they were separated into high-PLR (PLR-H), and low-PLR (PLR-L) groups with cutoff value of 300. Overall survival (OS) and recurrence-free survival (RFS) were analyzed. Results: Among all patients, the median follow-up time was 42 months. Age, gender, clinical manifestations, type of surgery, and T stage were similar in different NLR and PLR groups. Both NLR-H and PLR-H groups had higher rate of M1 stage of diseases (22.7% vs 9.4%, p = 0.04; 57.1% vs 8.8%, p < 0.01, respectively). PLR-H group had more presence of pseudomyxoma peritonei (PMP) (57.1% vs 15.2%, p = 0.03). In univariate analysis, factors such as age, gender, tumor perforation, and operation did not have impact on OS nor RFS. On the other hand, M1b stage is the only significantly poor prognostic factor on RFS (hazard ratio, 57.96, 95% CI, 5.16-651.23, p < 0.01). Conclusion: Both NLR-H and PLR-H had more M1 stage of diseases, but they were not correlated to OS nor RFS. PLR-H group had higher rate of presence PMP. Nevertheless, patients with LAMN and cellular PMP (M1b stage) had a higher rate of recurrence, and other factors showed no statistical difference in OS nor RFS.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on low-grade appendiceal mucinous neoplasm: A single tertiary hospital experience

Kuan

Liang

Lin

et al. 2022

Journal of the Chinese Medical Association

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“…Based on the work of Misdraji et al [14] in 2003, as outlined in the World Health Organization (WHO) Classification of Digestive System Tumors (2019), malignant mucinous neoplasms of the appendix can be divided into two categories as follows: LGMN (characterized by a low-grade neoplastic mucinous epithelium with extracellular mucin and thrusting tumor margins) and mucinous adenocarcinoma (characterized by infiltrative invasion).…”

Section: Discussionmentioning

confidence: 99%

Incidental appendiceal neoplasias: ten years' experience with 1,642 patients

2020

Signa Vitae

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Background: Acute appendicitis is the most common surgical emergency. In this study, we investigated the rate of neoplasia among patients who underwent an appendectomy in our center, a large Tertiary Care Teaching Hospital. Methods: We retrospectively reviewed 1,642 cases of appendectomies performed between 2007 and 2017. In this study, the data included demographic data, operative and pathological findings, and additional procedures following the appendectomy. Results: Of the 1,642 appendectomies, 1,294 were laparoscopic, and 348 were open procedures. Appendiceal neoplasia was encountered in the examination of appendix specimens taken from 20 patients. Sessile serrated adenoma (SSRA) was found in seven patients, neuroendocrine tumor (NET) in six patients, low-grade mucinous neoplasia (LGMN) in four patients, mucinous cystadenoma (MCA) in two patients, and diffuse adenoma (DA) in one patient. Two patients underwent right hemicolectomy due to positive surgical margins from previous surgeries. Colonoscopy and computed tomography (CT) control were performed on all neoplasia patients during the postoperative period, and no additional pathology was seen. Conclusions: Although the probability of neoplasia after appendectomy is low, it should be considered. Adenomas and neuroendocrine tumors seem to be the most common neoplasias that are incidentally encountered in appendectomy specimens.

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“…Two prior studies found no recurrence of disease following resection of nonmetastatic LAMN with a median follow-up of 4-5 years. 11,12 However, these studies were limited by low power and lack of stratification based on the extent of resection, and therefore, the true incidence of recurrence after resection of localized LAMNs is unclear. Furthermore, because these studies included few patients with T3-T4 lesions or did not evaluate T-category, the conclusions that can be drawn regarding higher T-category localized LAMNs are limited.…”

Section: Introductionmentioning

confidence: 99%

Necessity of posttreatment surveillance for low‐grade appendiceal mucinous neoplasms

Gupta

Brajcich

Yang

et al. 2021

Journal of Surgical Oncology

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Background and Objectives: Low-grade appendiceal mucinous neoplasms (LAMNs) are generally treated by surgical resection, but posttreatment surveillance protocols are not well-established. The objectives of this study were to characterize posttreatment surveillance and determine the risk of recurrence following surgical resection of LAMN.Methods: Patients who underwent surgical resection of localized LAMNs in an 11-hospital regional healthcare system from 2000 to 2019 were identified. Posttreatment surveillance regimens were characterized, and rates of disease recurrence were evaluated.Results: A total of 114 patients with LAMNs were identified. T-category was pTis for 92 patients (80.7%), pT3 for 7 (6.1%), pT4a for 14 (12.3%), and pT4b for 1 (0.9%).Two patients (1.8%) had a positive resection margin. Posttreatment surveillance was performed for 39 (34.2%) patients and consisted of office visits for 32 (82%) patients, computerized tomography imaging for 30 (77%), magnetic resonance imaging for 5 (13%), colonoscopy for 15 (38%), and serum tumor marker measurement for 12 (31%). After a mean follow-up duration of 4.7 years, no patients experienced tumor recurrence.Conclusions: Posttreatment surveillance is common among patients with LAMNs.However, no patients experienced tumor recurrence, regardless of T-category or margin status, suggesting that routine surveillance following surgical resection of LAMN may be unnecessary.

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Low-Grade Appendiceal Mucinous Neoplasms: A Single Institution Experience of 64 Cases With Clinical Follow-up and Correlation With the Current (Eighth Edition) AJCC Staging

Cited by 15 publications

References 14 publications

Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on low-grade appendiceal mucinous neoplasm: A single tertiary hospital experience

Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio on low-grade appendiceal mucinous neoplasm: A single tertiary hospital experience

Incidental appendiceal neoplasias: ten years' experience with 1,642 patients

Necessity of posttreatment surveillance for low‐grade appendiceal mucinous neoplasms

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