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Outcomes in Peritoneal Carcinomatosis from Appendiceal Goblet Cell Carcinoma Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC)

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Appendiceal goblet cell adenocarcinoma (GCA) is often misclassified and mistreated due to mixed histologic features. In general, cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is standard of care for peritoneal carcinomatosis (PC) from mucinous appendiceal tumors; however, in PC from GCA, data are limited and the role of CRS/HIPEC is controversial. We report outcomes in PC from appendiceal GCA treated with CRS/HIPEC.

Patients and Methods

A prospective institutional database of 391 CRS/HIPEC patients with appendiceal carcinomatosis from 1998 to 2018 was reviewed. Twenty-seven patients with GCA were identified. Perioperative variables were described. Survival was estimated using the Kaplan–Meier method.

Results

GCA occurred in 7% (27/391) of appendiceal CRS/HIPEC patients. Seven (26%) cases were aborted. Two patients underwent a second CRS/HIPEC for peritoneal recurrence. Median age at diagnosis was 53 years (range 39–72 years), and 12 (60%) were female. All underwent previous surgery. Seven (35%) had prior chemotherapy and received a median of 5 cycles (range 3–8). Median PCI was 6 (range 1–39). Complete cytoreduction was achieved in 95% (19/20). Grade III complications occurred in three (15%) patients, and no perioperative deaths occurred. Median follow-up was 97 months. Overall survival at 1, 3 and 5 years was 100%, 74% and 67%, respectively. Progression-free survival at 1, 3, and 5 years was 94%, 67% and 59%, respectively.

Conclusion

CRS/HIPEC should be considered as the main treatment option for patients with PC from appendiceal GCA. When performed at a CRS/HIPEC specialty center, 5-year OS of 67% can be achieved.

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Authors and Affiliations

  1. The Institute for Cancer Care, Mercy Medical Center, Baltimore, MD, USA

    Katherin Zambrano-Vera MD, Armando Sardi MD, FACS, Carlos Munoz-Zuluaga MD, Kimberley Studeman MD, Carol Nieroda MD, Michelle Sittig RN, Mary Caitlin King BS, Arkadii Sipok MD & Vadim Gushchin MD, FACS

Authors
  1. Katherin Zambrano-Vera MD
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  2. Armando Sardi MD, FACS
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  3. Carlos Munoz-Zuluaga MD
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  4. Kimberley Studeman MD
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  5. Carol Nieroda MD
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  6. Michelle Sittig RN
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  8. Arkadii Sipok MD
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  9. Vadim Gushchin MD, FACS
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Correspondence to Armando Sardi MD, FACS.

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Zambrano-Vera, K., Sardi, A., Munoz-Zuluaga, C. et al. Outcomes in Peritoneal Carcinomatosis from Appendiceal Goblet Cell Carcinoma Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC). Ann Surg Oncol 27, 179–187 (2020). https://doi.org/10.1245/s10434-019-07932-5

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