Skip to main content

Advertisement

SpringerLink
Log in

Effects of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Treatment of Goblet Cell Carcinoma: A Prospective Cohort Study

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Goblet cell carcinoma (GCC) of the appendix is a rare disease. Treatment options vary according to disease staging. Cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) may improve survival in patients with peritoneal spreading.

Objective

The aim of this study was to examine the prognosis of patients with appendiceal GCC treated per protocol, and to evaluate the results of CRS+HIPEC in cases of peritoneal spreading.

Methods

From 2009 to 2016, a total of 48 GCC patients were referred to the European Neuroendocrine Tumour Center of Excellence, Aarhus University Hospital. All patients received treatment per protocol according to disease staging. In patients with localized disease, the treatment was a right hemicolectomy. Patients with peritoneal spread who met the inclusion criteria for CRS + HIPEC, as well as patients with high-risk features of developing peritoneal spread, received CRS + HIPEC. If too-extensive disease was found, palliative chemotherapy was offered.

Results

Overall survival for patients with localized disease (n = 6) or deemed at risk of peritoneal spread (n = 8) was 100% after a median follow-up of 3.5 years. In patients with peritoneal spread and eligible for CRS+HIPEC(n = 27), the median survival was 3.2 years [95% confidence interval (CI) 2.3–4.1] and the 5-year survival rate was 57%. In contrast, the median survival for patients with too-extensive intraperitoneal disease (n = 7) was 1.3 years (95% CI 0.6–2.0), with a 3-year survival rate of 20%.

Conclusions

Long-term survival can be achieved in patients with peritoneal spread treated with CRS + HIPEC. CRS+HIPEC was associated with a favorable outcome in GCC patients at high-risk of developing peritoneal spread.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1 
Fig. 2

Similar content being viewed by others

References

  1. Bosman F, Carneiro F, Hruban R, Theise N (eds). WHO Classification of Tumours of the Digestive System. Geneva: WHO; 2010.

    Google Scholar 

  2. Pape U-F, et al. ENETS Consensus Guidelines for the Management of Patients with Neuroendocrine Neoplasms from the Jejuno-Ileum and the Appendix Including Goblet Cell Carcinomas. Neuroendocrinology. 2012;95:135–156.

    Article  CAS  PubMed  Google Scholar 

  3. Pham T H, Wolff B, Abraham SC, Drelichman E. Surgical and chemotherapy treatment outcomes of goblet cell carcinoid: a tertiary cancer center experience. Ann. Surg. Oncol. 2006;13:370–376.

    Article  PubMed  Google Scholar 

  4. McCusker ME, Coté TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973–1998. Cancer. 2002;94:3307–3312.

    Article  PubMed  Google Scholar 

  5. Tang LH, et al. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol. 2008;32:1429–1443.

    Article  PubMed  Google Scholar 

  6. Kanthan R, Saxena A, Kanthan SC. Goblet cell carcinoids of the appendix: immunophenotype and ultrastructural study. Arch Pathol Lab Med. 2001;125:386–390.

    CAS  PubMed  Google Scholar 

  7. Hemminki K, et al. Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer. 2001;92:2204–2210.

    Article  CAS  PubMed  Google Scholar 

  8. Holt N, Grønbæk H. Goblet cell carcinoids of the appendix. Sci World J. 2013. https://doi.org/10.1155/2013/543696.

    Google Scholar 

  9. Rossi RE, et al. Goblet cell appendiceal tumors e Management dilemmas and long-term outcomes. Surg. Oncol. 2015;24:47–53.

    Article  PubMed  Google Scholar 

  10. Olsen IH, et al. Goblet cell carcinoids: characteristics of a Danish cohort of 83 patients. PLoS One. 2015;10:e0117627.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lamarca A, et al. Appendiceal Goblet Cell Carcinoids: Management Considerations from a Reference Peritoneal Tumour Service Centre and ENETS Centre of Excellence. Neuroendocrinology. 2016;103(5):500–17.

    Article  CAS  PubMed  Google Scholar 

  12. Plöckinger U, et al. Consensus Guidelines for the Management of Patients with Digestive Neuroendocrine Tumours: Well-Differentiated Tumour/Carcinoma of the Appendix and Goblet Cell Carcinoma. Neuroendocrinology. 2008;87:20–30.

    Article  PubMed  Google Scholar 

  13. Mahteme H, Sugarbaker PH. Treatment of peritoneal carcinomatosis from adenocarcinoid of appendiceal origin. Br J Surg. 2004;91:1168–1173.

    Article  CAS  PubMed  Google Scholar 

  14. Cashin P, et al. Appendiceal adenocarcinoids with peritoneal carcinomatosis treated with cytoreductive surgery and intraperitoneal chemotherapy: a retrospective study of in vitro drug sensitivity and survival. Clin Colorectal Cancer. 2011;10:108–112.

    Article  CAS  PubMed  Google Scholar 

  15. McConnell YJ, et al. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: an emerging treatment option for advanced goblet cell tumors of the appendix. Ann Surg Oncol. 2014;21:1975–82.

    Article  PubMed  Google Scholar 

  16. Cashin PH, Dranichnikov F, Mahteme H. Cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy treatment of colorectal peritoneal metastases: cohort analysis of high volume disease and cure rate. J. Surg. Oncol. 2014;110:203–206.

    Article  PubMed  Google Scholar 

  17. Kuijpers AMJ, et al. Cytoreduction and HIPEC in The Netherlands: nationwide long-term outcome following the Dutch protocol. Ann Surg Oncol. 2013;20(13):4224–30.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Verwaal VJ, Bruin S, Boot H, van Slooten G, van Tinteren H. 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol. 2008;15:2426–2432.

    Article  PubMed  Google Scholar 

  19. Iversen LH, Rasmussen PC, Hagemann-Madsen R, Laurberg S. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis: the Danish experience. Color Dis. 2013;15:365–372.

    Article  Google Scholar 

  20. Sobin LH, Gospodarowicz M, Wittekind C. TNM Classification of Malignant Tumours. Wiley, Hoboken, 2011.

    Google Scholar 

  21. Radomski M. et al. Curative surgical resection as a component of multimodality therapy for peritoneal metastases from goblet cell carcinoids. Ann Surg Oncol. 23, 4338–4343 (2016).

    Article  PubMed  Google Scholar 

  22. Randle RW, et al. Appendiceal goblet cell carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J Surg Res. 2015;196:229–234.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rollven E, Abraham-Nordling M, Holm T, Blomqvist L. Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography. Cancer Imaging. 2013;17:3.

    Article  Google Scholar 

Download references

Disclosure

Anders Husted Madsen, Morten Ladekarl, Gerda Elisabeth Villadsen, Henning Grønbæk, Mette Møller Sørensen, Katrine Stribolt, Vic Jilbert Verwaal, and Lene Hjerrild Iversen have no disclosures to declare.

Author information

Authors and Affiliations

  1. Department of Surgery, Aarhus University Hospital, Aarhus C, Denmark

    Anders Husted Madsen MD, PhD, Mette Møller Sørensen MD, PhD, Vic Jilbert Verwaal MD, PhD & Lene Hjerrild Iversen MD, PhD, DMSci

  2. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

    Morten Ladekarl MD, DMSci

  3. Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark

    Gerda Elisabeth Villadsen MD, PhD & Henning Grønbæk MD, PhD

  4. Department of Pathology, Aarhus UniversityHospital, Aarhus, Denmark

    Katrine Stribolt MD

Authors
  1. Anders Husted Madsen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Morten Ladekarl MD, DMSci
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gerda Elisabeth Villadsen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Henning Grønbæk MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mette Møller Sørensen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katrine Stribolt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vic Jilbert Verwaal MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Lene Hjerrild Iversen MD, PhD, DMSci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lene Hjerrild Iversen MD, PhD, DMSci.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Madsen, A.H., Ladekarl, M., Villadsen, G.E. et al. Effects of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Treatment of Goblet Cell Carcinoma: A Prospective Cohort Study. Ann Surg Oncol 25, 422–430 (2018). https://doi.org/10.1245/s10434-017-6272-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-017-6272-x

Keywords

Search

Navigation