Appendiceal tumors

Connor, Saxon; Hanna, G. B.; Frizelle, Frank

doi:10.1007/bf02236899

Cited by 522 publications

(160 citation statements)

References 20 publications

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“…This rate is similar to that found in another study [11], which observed that 8 primary appendiceal adenocarcinomas were found in a review of 7,980 appendectomy specimens (incidence 0.1%). Studies have shown that the mean age of patients with appendiceal adenocarcinoma is in the sixth decade, with a range of 28–89 years [6, 8].…”

Section: Discussionsupporting

confidence: 78%

Clinicopathologic Features and Predictors for Survival of Mucinous and Nonmucinous Appendiceal Adenocarcinoma

Chen¹,

Liao²,

Yeh³

et al. 2008

Dig Surg

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Background/Aims: We report a study in patients with mucinous and nonmucinous appendiceal adenocarcinoma treated surgically whose records were examined to elucidate their clinicopathologic features and prognostic factors for survival. Methods: The medical records of 34 patients with mucinous and nonmucinous appendiceal adenocarcinoma (1991–2005) were retrospectively reviewed. Results: There was no significant difference between mucinous and nonmucinous tumors in patient demographics, clinicopathologic features, type of operation and outcome. Nonmucinous tumors had a higher incidence of leukocytosis than mucinous ones. The overall 5-year survival rate for 34 patients with appendiceal adenocarcinoma was 35.8%. In the univariate analysis, predictors of survival were the type of operation, resectability, carcinomatosis and tumor stage. Tumor stage significantly influenced patient survival in the multivariate analysis. Conclusion: Mucinous appendiceal adenocarcinoma had clinicopathologic characteristics and a prognosis similar to nonmucinous, except that there was more leukocytosis in nonmucinous tumors. Tumor stage is an independent predictor for survival among patients with appendiceal adenocarcinoma.

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Section: Discussionsupporting

confidence: 78%

Clinicopathologic Features and Predictors for Survival of Mucinous and Nonmucinous Appendiceal Adenocarcinoma

Chen¹,

Liao²,

Yeh³

et al. 2008

Dig Surg

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“…Appendiceal tumor, e.g., is rare though, with overall rates of less than 1% [25,26]. It should mainly be considered in patients aged >40 years.…”

Section: Why Do Not Remove All Of Them?mentioning

confidence: 99%

“…If the clinical condition improves, patients are usually discharged and the antibiotic course is completed at home. If treatment has been successful, a colonoscopy and an ultrasound or a CT scan within 6 months are usually recommended to rule out underlying malignant disease, at least in patients with a reasonable risk thereof (usually in patients older than 40 years) [1,26,27]. …”

Section: Treatment Of Appendicitismentioning

confidence: 99%

Clinical Management of Appendicitis

2018

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Background: Ever since the first appendectomy has been performed, surgery has been the standard of care for acute appendicitis, with antibiotic therapy being reserved for special situations. Recent studies have shown the feasibility of antibiotic therapy for uncomplicated appendicitis. Methods: This clinical therapeutic review is based both on author expertise and a selective literature survey in PubMed based on the term ‘appendicitis', combined with the terms ‘acute', ‘complicated', ‘conservative', ‘non-operative', ‘therapy', ‘surgery', and ‘strategy'. According to these search results as well as to the treatment guidelines from the American College of Surgeons, Society for Surgery of the Alimentary Tract, Society of American Gastrointestinal and Endoscopic Surgeons, European Association of Endoscopic Surgery, and World Society of Emergency Surgery, we present an interdisciplinary treatment concept. Results: Approximately 90% of patients treated with antibiotics are able to avoid surgery during the initial admission. The other 10% that fail to respond to antibiotics require a rescue appendectomy. Recurrence rates of non-operated patients within 1 year are as high as 20-30%. Conclusion: In uncomplicated appendicitis without risk factors for failure of non-operative management, a shared decision based on the patient's preferences should be made. In cases with risk factors, appendectomy is still the treatment recommended. If the diagnosis is uncertain or clinical symptoms are rather mild, antibiotic therapy should be started. In complicated appendicitis, management depends on the clinical state, with either immediate surgery or primarily antibiotic therapy and combined with drainage of abscess, being followed by interval appendectomy in some cases.

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“…Neoplasms from the appendix are rare, accounting for <1% of appendicectomy specimens [1]. The most frequent subtype of appendiceal malignancies is well-differentiated neuroendocrine tumours (NETs; previously known as carcinoid tumours), followed by adenocarcinomas [2].…”

Section: Introductionmentioning

confidence: 99%

Appendiceal Goblet Cell Carcinoids: Management Considerations from a Reference Peritoneal Tumour Service Centre and ENETS Centre of Excellence

Lamarca¹,

Nonaka²,

Escola³

et al. 2015

Neuroendocrinology

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Background: Appendix goblet cell carcinoids are known to share histological features of adenocarcinoma and neuroendocrine tumours. Due to their low incidence, quality evidence is lacking for the management of these patients. Methods: We performed a single-centre retrospective study of patients with a confirmed diagnosis of appendiceal goblet cell carcinoid (GCC; 1996-2014). Patients were divided into curative intent (CI) and palliative intent (PI) cohorts. Our primary end point was overall survival (OS). Results: Seventy-four patients were eligible; 76% were treated with CI [surgery only (36%), cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC; 36%), adjuvant chemotherapy (20%) and a combination of CRS and HIPEC followed by adjuvant chemotherapy (9%)], and 23% had advanced-stage disease amenable to palliative treatment (chemotherapy or supportive care) only. Completion right hemicolectomy, performed in 64% of the CI cohort, did not impact on the relapse rate or disease-free survival. FOLFOX chemotherapy was used in both the adjuvant and palliative settings; safety was as expected, and we observed a high rate (60%) of disease control in the palliative cohort. The estimated median OS (all patients), disease-free survival (CI patients) and progression-free survival (PI patients) were 52.1 (95% CI 29.4-90.3), 75.9 (26.6-not reached) and 5.3 (0.6-5.7) months, respectively. Age and stage were independent factors associated with OS in the multivariable analysis. Tang classification showed a trend for impact on OS. No benefit from specific adjuvant approach was identified; however, selection bias for treatment approach was observed. Conclusion: Prospective trials are needed to define optimal approaches in GCC. All GCC patients should be managed by specialized centres due to their esoteric behaviour; we provide management considerations based on our experience and conclusions.

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Appendiceal tumors

Cited by 522 publications

References 20 publications

Clinicopathologic Features and Predictors for Survival of Mucinous and Nonmucinous Appendiceal Adenocarcinoma

Clinicopathologic Features and Predictors for Survival of Mucinous and Nonmucinous Appendiceal Adenocarcinoma

Clinical Management of Appendicitis

Appendiceal Goblet Cell Carcinoids: Management Considerations from a Reference Peritoneal Tumour Service Centre and ENETS Centre of Excellence

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