Cancers of the appendix are rare. Most of them are found accidentally on appendectomies performed for appendicitis. When reviewed, majority of the tumors were carcinoid, adenoma, and lymphoma. Adenocarcinomas of appendix are only 0.08% of all cancers and the treatment remains controversial. Here we are reporting a 46-year-old male presented with symptoms of appendicitis, diagnosed with adenocarcinoma of the appendix. The patient was treated with appendectomy and refused further surgical intervention to complete hemicolectomy. Up to date, he remains asymptomatic. We performed literature review of the tumors of the appendix. Most of the benign conditions are treated with surgery alone. Lymphomas require CHOP-like chemotherapy and carcinoid syndrome treatment with somatostatin analogues. It is generally recommended that right hemicolectomy is the preferred treatment for adenocarcinoma of appendix. The role of chemotherapy is unclear due to lacking randomized trials but seems to be accepted if there is lymph node involvement or peritoneal seeding.
116 Background: Epirubicin, cisplatin, and 5-FU (ECF) improves overall survival for advanced esopgagogastric adenocarcinoma compared with other protocols but is associated with considerable toxicity. A triple chemotherapy with TCX has shown improved survival with less toxicity at our institution. The aims of this study were to retrospectively analyze overall survival and toxicity of TCX in our patient population and to compare them with published results from ECF and paclitaxel, cisplatin, and 5-FU (TCF), a similar regimen to ours. Methods: We analyzed pts with locally advanced and/or metastatic esophagogastric adenocarcinoma treated in our institution from 2005 to 2012 with TCX (paclitaxel 80mg/m^2 day 1 & 8, carboplatin 5 AUC day 1, capecitabine 750mg/m^2 BID for 14 days). Pts had received no prior chemotherapy. Primary endpoint was overall survival and secondary endpoint was toxicity. We compared our data to historical results from trials of ECF and TCF. Results: 35 pts who received TCX were identified. The median age was 64 years (range 37-91). 20 pts had metastatic disease and 15 had locally advanced disease. Median survival was 21 months (95% CI: 13, 25 months). 1 year survival was 72% (95% CI: 54%, 90%). These data compare favorably to published ECF data (table) with a significant survival benefit of TCX over ECF (p<0.05%). When compared to TCF in pts with metastatic disease 2 year survival was 18%, compared to 32% (95% CI: 10%, 54%) with TCX. Though there is a survival benefit, it was not statistically significant. Grade 3-4 toxicity with ECF has been documented in several studies as above 40%. In our patients treated with TCX, only 4 pts (11%) suffered grade 3-4 toxicity (nausea, vomiting, hearing loss, and neutropenia). Conclusions: In our patient population, triple therapy of paclitaxel, carboplatin, and capecitabine (TCX) is associated with significant improvement in overall survival in advanced esophagogastric cancer with a low rate of toxicity compared to published ECF results. [Table: see text]
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.