Abstract
Purpose: Appendiceal adenocarcinomas are very rare. We analyzed contemporary outcomes associated with surgical therapies for these malignancies. Methods: Retrospective outcomes for patients treated at a tertiary academic medical center from 1981 through 2001 were analyzed. Results: A total of 36 patients (22 females (61 percent) mean age, 52 years) with appendiceal adenocarcinoma were treated. Eighty-eight percent of patients presented with symptoms of acute appendicitis. Eighteen (50 percent) patients underwent curative resection (7 primary right hemicolectomies, 10 appendectomies + subsequent right hemicolectomy, and 1 appendectomy alone). Mean length of follow-up was 55 months. Overall five-year survival rate was 46 percent. The five-year survival rate after curative resection was 61 percent and after palliative surgery was 32 percent (P < 0.05). Among patients who underwent curative resection, factors associated with improved five-year survival rates included histologic type (79 vs. 32 percent for colonic vs. mucinous types, respectively; P < 0.05), T stage (75 vs. 47 percent for T1 and 2 vs. T3 and 4, respectively; P < 0.05), and tumor grade (100 vs. 46 percent for well-differentiated tumors vs. moderately or poorly differentiated tumors, respectively; P < 0.05). Conclusions: Patients undergoing surgery for appendiceal adenocarcinoma can be stratified according to prognostic variables. The role of adjuvant therapies for patients with poor prognostic factors needs to be evaluated in a multi-institutional setting.
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References
Nitecki SS, Wolff BG, Schlinkert R, Sarr MG. The natural history of surgically treated primary adenocarcinoma of the appendix. Ann Surg 1994; 219: 51–7
Chang P, Attiyeh FF. Adenocarcinoma of the appendix. Dis Colon Rectum 1981; 24: 176–80
Lenriot JP, Huguier M. Adenocarcinoma of the appendix. Am J Surg 1988; 155: 470–5
AJCC. AJCC cancer staging manual. 5th ed. Philadelphia: Lippincott-Raven, 1997.
Kaplan F, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 63: 475–81
Hinson FL, Ambrose NS. Pseudomyxoma peritonei. Br J. Surg 1998; 85: 1332–9
McCusker ME, Cote TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a populationbased study from the surveillance, epidemiology and end-results program, 1973–1998. Cancer 2002; 94: 3307–12
Cortina R, McCormick J, Kolm P, Perry RR. Management and prognosis of adenocarcinoma of the appendix. Dis Colon Rectum 1995; 38: 848–52
Connor SJ, Hanna GB, Frizelle FA. Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7, 970 appendectomies. Dis Colon Rectum 1998; 41: 75–80
Proulx GM, Willett CG, Daley W, Shellito PC. Appendiceal carcinoma: patterns of failure following surgery and implications for adjuvant therapy. J Surg Oncol 1997; 66: 51–3
Kabbani W, Houlihan PS, Luthra R, et al. Mucinous and nonmucinous appendiceal adenocarcinomas: different clinicopathological features but similar genetic alterations. Mod Pathol 2002; 15: 599–605
McBroom JW, Parker MF, Krivak TC, et al. Primary appendiceal malignancy mimicking advanced stage ovarian carcinoma: a case series. Gynecol Oncol 2000; 78: 388–90
Chen YC, Chiang JM. Appendiceal intussusception with adenocarcinoma mimicking a cecal polyp. Gastrointest Endosc 2000; 52: 130–1
Nascimbeni R, Burgart LJ, Nivatvongs S, Larson DR. Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum 2002; 45: 200–6
Blumberg D, Paty PB, Guillem JG, et al. All patients with small intramural rectal cancers are at risk for lymph node metastasis. Dis Colon Rectum 1999; 42: 881–5
Gallo JL, Martinez-Ossa R, Ferrer G, Camara M. Mucinous appendicular cystadenocarcinoma and pregnancy. Am J Perinatol 2001; 18: 155–7
Sehouli J, Kopetsch OJ, Ricke J, et al. Primary mucinous adenocarcinoma of the appendix: a rare entity in the differential diagnosis of ovarian cancer. J Obstet Gynaecol Res 2000; 26: 333–9
Ozakyol AH, Saricam T, Kabukcuoglu S, et al. Primary appendiceal adenocarcinoma. Am J Clin Oncol 1999; 22: 458–9
Gough DB, Donohue JH, Schutt AJ, et al. Pseudomyxoma peritonei. Long-term patient survival with an aggressive regional approach. Ann Surg 1994; 219: 112–9
Sugarbaker PH, Chang D. Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol 1999; 6: 727–31
Smith JW, Kemeny N, Caldwell C, et al. Pseudomyxoma peritonei of appendiceal origin. The Memorial Sloan-Kettering Cancer Center experience. Cancer 1992; 70: 396–401
Ronnett BM, Zahn CM, Kurman RJ, et al. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei. Am J Surg Pathol 1995; 19: 1390–408
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Ito, H., Osteen, R.T., Bleday, R. et al. Appendiceal adenocarcinoma: Long-term outcomes after surgical therapy. Dis Colon Rectum 47, 474–480 (2004). https://doi.org/10.1007/s10350-003-0077-7
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DOI: https://doi.org/10.1007/s10350-003-0077-7