The Utility of Preoperative Tumor Markers in Peritoneal Carcinomatosis from Primary Appendiceal Adenocarcinoma: an Analysis from the US HIPEC Collaborative

Fackche, Nadege; Schmocker, Ryan K.; Kubi, Boateng; Cloyd, Jordan M.; Ahmed, Ahmed; Grotz, Travis E.; Leiting, Jennifer L.; Fournier, Keith F.; Lee, Andrew; Powers, Benjamin D.; Dineen, Seán; Veerapong, Jula; Baumgartner, Joel M.; Clarke, Callisia N.; Gamblin, T. Clark; Patel, Sameer H.; Dhar, Vikrom K.; Hendrix, Ryan J.; Lambert, Laura; Abbott, Daniel E.; Pokrzywa, Courtney; Lafaro, Kelly J.; Lee, Byrne; Zaidi, Mohammad Y.; Maithel, Shishir K.; Johnston, Fabian M.; Greer, Jonathan B.

doi:10.1007/s11605-021-04953-y

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…demonstrated that PCI score, calculated at CRS ± HIPEC, for 65 patients with appendiceal adenocarcinoma, was both representative of disease volume and was a significant factor resulting in poorer OS and DFS ( p < 0.05). Fackche et al., 23 from a larger cohort of 409 patients with peritoneal mucinous adenocarcinoma treated with CRS ± HIPEC across multiple institutions, also found that PCI was an independent predictor of DFS.…”

Section: Discussionmentioning

confidence: 91%

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Impact of neoadjuvant systemic chemotherapy followed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal adenocarcinoma

Flood

Roberts

Mitchell

et al. 2023

Asia-Pac J Clncl Oncology

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AimPeritoneal dissemination of infiltrative appendiceal tumors is a rare and poorly understood phenomenon. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a well‐recognized treatment option for selected patients. Neoadjuvant systemic chemotherapy (NAC) has been shown to be associated with improved overall survival (OS) in colorectal peritoneal metastases but little is known of the impact of this from an appendiceal adenocarcinoma perspective.MethodA prospective database of 294 patients with advanced appendiceal primary tumors undergoing CRS ± HIPEC between June 2009 and December 2020 was reviewed. Baseline characteristics and long‐term outcomes were compared between patients with adenocarcinoma who received neoadjuvant chemotherapy or upfront surgery.ResultsEighty‐six (29%) patients were histologically diagnosed with an appendiceal cancer. These included intestinal‐type adenocarcinoma (11.6%), mucinous adenocarcinoma (43%), and goblet cell adenocarcinoma (GCA) or signet ring cell adenocarcinoma (SRCA) (45.4%). Twenty‐five (29%) of these underwent NAC, of which eight (32%) exhibited some degree of radiological response. There was no statistical difference in OS at 3 years between the NAC and upfront surgery groups (47.3% vs. 75.8%, p = 0.372). Appendiceal histology subtypes, particularly GCA and SRCA (p = 0.039) and peritoneal carcinomatosis index >10 (p = 0.009), were factors independently associated with worse OS.ConclusionAdministration of NAC did not appear to prolong OS in the operative management of disseminated appendiceal adenocarcinomas. GCA and SRCA subtypes display a more aggressive biological phenotype.

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Section: Discussionmentioning

confidence: 91%

“…Fackche et al, 23 from a larger cohort of 409 patients with peritoneal mucinous adenocarcinoma treated with CRS ± HIPEC across multiple institutions, also found that PCI was an independent predictor of DFS.…”

Section: Univariate Analysismentioning

confidence: 91%