Clinicopathologic Features and Survival Outcomes of Signet Ring Cell Carcinoma of the Appendix: An Analysis of the Surveillance, Epidemiology, and End Results Database

Abushalha, Kamelah; Tuqan, Wael; Albagoush, Sara; Abulaimoun, Sawsan; Silberstein, Peter T.

doi:10.7759/cureus.8549

Cited by 4 publications

(11 citation statements)

References 14 publications

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“…We found that over one-half cases presented with metastatic disease, and SC had almost twice the odds of metastasis at diagnosis than CA. Studies have reported the five-year cancer-specific survival of metastatic appendiceal GC to be 4-7%, and a median survival of only 19 months, in contrast to 60 months for nonmetastatic disease [ 4 , 14 ]. Our study found the median survival of metastatic disease to be similar at 20 months.…”

Section: Discussionmentioning

confidence: 99%

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Frequency and Risk Factors for Metastasis in Newly Diagnosed Appendiceal Carcinoma

Minhas¹,

Hendrickson²,

Minhas³

2021

Cureus

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BackgroundAppendiceal carcinoma has an insidious clinical presentation, and these tumors are rarely suspected prior to surgery, potentially leading to late diagnosis. The aim of this study is to investigate the prevalence of metastatic disease at initial presentation and potentially associated sociodemographic characteristics. MethodsPatients were identified from the Surveillance, Epidemiology, and End Results (SEER) program using the International Classification of Diseases for Oncology-3 (ICD-O-3) histology/behavior codes between 2010 and 2015. Firth logistic regression was performed to determine the association of metastasis at presentation with tumor subtype, adjusted for age, race, sex, insurance and marital status, tumor grade, and tumor and nodal stage using the 7th edition of the American Joint Committee on Cancer (AJCC) staging system. ResultsWe identified a total of 3,447 patients with known metastatic status. A total of 38.4% had metastatic disease at diagnosis. Compared to colonic-type adenocarcinoma (CA), mucinous adenocarcinoma (MA) and signet ring cell carcinoma (SC) were more likely to present with metastasis at diagnosis (OR: 2.34; 95% CI [1.80-3.06]; OR: 1.93 [1.29-2.89], respectively), however, goblet cell carcinoma (GC) was less likely (OR: 0.59 [0.36-0.93]). Compared to tumors invading the submucosa (T1 stage), tumors invading deeper through the visceral peritoneum or nearby organs (T4 stage) were significantly more likely to present with metastatic disease ). Tumors invading the muscularis propria (T2 stage) or deeper into the subserosa, or the mesoappendix (T3 stage) were less likely to present with metastatic disease (OR: 0.34 [0.16-0.71]); OR: 0.55 [0.34-0.91], respectively). Compared to no regional lymph node spread, four or more regional lymph node involvement (N2 stage) was more likely to present with metastatic disease (OR: 2.19 [1.53-3.16]). Men were less likely to present with metastatic disease (OR: 0.60 [0.48-0.73]). A total of 90.1% of CA, 84.2% of GC, 42.2% of MA, and 78.5% of SC patients with metastasis at diagnosis had extraperitoneal distant metastasis (M1b). ConclusionsA significant proportion of patients with newly diagnosed appendiceal carcinoma presented with metastatic disease, concerning substantial diagnostic delay and potentiating the need for aggressive treatments. Predictors of metastatic disease included female sex, histologic subtype, and significant regional lymph node involvement. Future research should focus on earlier detection and explore tumor biology.

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Section: Discussionmentioning

confidence: 99%

“…The presence of metastases greatly influences the clinical course of patients with appendiceal carcinoma. Metastatic disease confers poor prognosis and entails difficult treatments [2][3][4][5]. Due to the rarity of appendiceal carcinoma, epidemiological data on metastatic disease at presentation is limited.…”

Section: Introductionmentioning

confidence: 99%

Frequency and Risk Factors for Metastasis in Newly Diagnosed Appendiceal Carcinoma

Minhas¹,

Hendrickson²,

Minhas³

2021

Cureus

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“…Similar to mucinous adenocarcinoma, SRCC-A may have distant metastases at diagnosis, and 64% of patients have lymph node metastasis, which is significantly higher than that of other histological types. [1,2] Zheng et al confirmed that SRCC-A is a distant tumor, accounting for 66.5% of the total cases. [8] Ovary and peritoneum are common sites of metastasis, and Kulkarni et al concentrated on the ovarian implantation metastasis and extensive peritoneum metastasis.…”

Section: Discussionmentioning

confidence: 99%

“…Primary tumors of the appendix represent approximately 0.4% of all gastrointestinal tract tumors, and are mainly found in about 1% of appendectomies. [1] The most frequent location of tumors with the signet ring cell pattern is the stomach (96%), followed by the colon, rectum, gallbladder, and pancreas. Signet-ring cell carcinoma (SRCC), which is an infrequent type of colorectal cancer, accounts for 0.5% to 2.6% of all adenocarcinomas.…”

Section: Introductionmentioning

confidence: 99%

Clinical benefits of FOLFOXIRI combined with bevacizumab for advanced-stage primary signet ring cell carcinoma of the appendix: A case report

Huang

Wang

et al. 2023

Medicine

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Rationale: Signet-ring cell carcinoma, which is an infrequent type of colorectal cancer. Abdominal pain is the primary presenting complaint of patients with acute appendicitis. It is difficult to diagnose patients with appendiceal carcinomas accompanying with symptoms of acute appendicitis. Patient Concerns: A 33-year-old female patient was admitted to our hospital, with chief complaints of “bilateral pelvic space-occupying lesions for 1 month, aggravated abdominal distension, and she accompanied with diarrhea for 3 days.” Diagnosis: The patient was with primary signet ring cell carcinoma of the appendix, presented with acute appendicitis, as well as bilateral ovarian metastasis and peritoneal implantation metastasis. Interventions: She was then treated with irinotecan, oxaliplatin, calcium folinate, 5-FU combined with bevacizumab, surgical treatment, and postoperative adjuvant treatment with oxaliplatin, capecitabine regimen to consolidate the efficacy. Outcomes: The patient is in good conditions, and postoperative adjuvant chemotherapy is in progress as well. Conclusion: The outcomes highlighted the importance of strict histopathologic assessment for appendiceal adenocarcinoma, and provided new ideas for the diagnosis and treatment of advanced-stage signet ring cell carcinoma of the appendix.

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“…Sin embargo, la efectividad de estos regímenes de quimioterapia sigue siendo controvertida (1,17) . El papel de la quimioterapia no está claramente establecido, aunque los casos con enfermedad estadio IV pueden ser tratados con quimioterapia adyuvante basada en 5-fluorouracilo, en forma similar a los adenocarcinomas colorrectales (18,19) . La paciente del presente caso fue sometida a quimioterapia con resultados favorables.…”

Section: Discussionunclassified

Tumor carcinoide de células caliciformes apendicular con metástasis endometrial

Rondón-Tapía¹,

Torres-Cepeda²

2022

Rev peru ginecol obstet.

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El tumor carcinoide de células caliciformes es una neoplasia mixta casi exclusiva del apéndice, con diferenciación neuroendocrina y mucinosa. La afección metastásica endometrial por carcinomas extragenitales, especialmente el tipo de células de anillo de sello, es rara. Se presenta un caso de tumor carcinoide de células caliciformes apendicular con metástasis endometrial. Se trató de paciente femenina de 70 años quien presentó sangrado genital. El examen ginecológico mostró sangrado genital en moderada cantidad de color rojo-marrón y cuello uterino endurecido. En la biopsia endometrial se halló nidos de células de anillo de sello. La impresión diagnóstica provisional fue carcinoma mal diferenciado de probable origen intestinal. Durante la intervención, el útero tenía consistencia pétrea, el apéndice cecal era fibrótico y engrosado y el epiplón engrosado con nódulos tumorales. Las secciones anatómicas del cuello y cuerpo uterino mostraron focos tumorales. En el apéndice cecal se encontró acúmulos de pequeño tamaño compuestos por células caliciformes. La inmunotinción fue positiva a sinaptofisina, CDX-2, EMA, CK20, CD56 focal. Estos hallazgos confirmaron el diagnóstico de tumor carcinoide de células caliciformes, un tumor caracterizado por infiltración de la pared apendicular por pequeños nidos o cordones de células caliciformes con mucina intracitoplasmática y expresión focal de marcadores neuroendocrinos. Estas neoplasias tienen un comportamiento más agresivo que los tumores neuroendocrinos. La metástasis endometrial es rara y puede ser confundida con un carcinoma primario de células de anillo de sello. Se debe considerar como diagnóstico diferencial después de excluir otros tumores primarios.

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Clinicopathologic Features and Survival Outcomes of Signet Ring Cell Carcinoma of the Appendix: An Analysis of the Surveillance, Epidemiology, and End Results Database

Cited by 4 publications

References 14 publications

Frequency and Risk Factors for Metastasis in Newly Diagnosed Appendiceal Carcinoma

Frequency and Risk Factors for Metastasis in Newly Diagnosed Appendiceal Carcinoma

Clinical benefits of FOLFOXIRI combined with bevacizumab for advanced-stage primary signet ring cell carcinoma of the appendix: A case report

Tumor carcinoide de células caliciformes apendicular con metástasis endometrial

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