Surgical and Chemotherapy Treatment Outcomes of Goblet Cell Carcinoid: A Tertiary Cancer Center Experience

Pham, Tuan H.; Wolff, Bruce G.; Abraham, Susan C.; Drelichman, Ernesto R.

doi:10.1245/aso.2006.02.016

Cited by 116 publications

(134 citation statements)

References 14 publications

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“…Abdominal pain was the most common symptom in all of 3 subsets of patients in our study, with symptoms compatible with acute appendicitis (right, lower-quadrant pain with acute onset) more commonly occurring in patients in groups 1 and 2, and chronic abdominal pain more common for patients in groups 3 and 4. Our data are consistent with previously published studies 6,9,22,24,[26][27][28] that have reported abdominal pain or other symptoms of acute appendicitis as the most common presentation for patients with GCT. Others 8,14,27 have noted that when the patient presents with metastases in the lower abdomen and pelvis, the presentation may be atypical.…”

Section: Commentsupporting

confidence: 93%

“…Some studies 14,20,24,38 advocate further surgery in all patients, whereas others suggest additional resection only for patients with positive margins, significant atypia, increased mitoses (2 per 10 high-power fields), increased Ki-67 staining (.3%), clinically involved lymph nodes, or metastatic disease. 5,8,11,18,[26][27][28]39 In our study, 14 of 30 patients (47%) with tumors containing a GCT component had residual disease in right colectomy specimens, either in the intestinal wall, the peri-intestinal soft tissue, and/or lymph nodes, including 36% (5 of 14) of the patients in group 1. This greater frequency of residual disease may represent a referral bias at our institution.…”

Section: Commentmentioning

confidence: 52%

“…These data have prompted suggestions of prophylactic oophorectomy in postmenopausal women. 8,25,26 A few studies share their experience with chemotherapy in GCT and mixed GCT/adenocarcinoma, including intraperitoneal chemotherapy, and report that temporary control was achieved with some reports suggesting survival benefit, 14,26,40,41,42 and others showing a lack of response to systemic chemotherapy. 31 We agree with others that these tumors represent a continuum of GCT and GCT with varying amounts of adenocarcinoma (or adenocarcinoma ex GCT).…”

Section: Commentmentioning

confidence: 99%

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Goblet Cell Carcinoid Tumor, Mixed Goblet Cell Carcinoid-Adenocarcinoma, and Adenocarcinoma of the Appendix: Comparison of Clinicopathologic Features and Prognosis

Taggart

Abraham²,

Overman³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context.-The prognosis of appendiceal goblet cell carcinoid tumors (GCTs) is believed to be intermediate between appendiceal adenocarcinomas and conventional carcinoid tumors. However, GCTs can have mixed morphologic patterns, with variable amount of adenocarcinoma.Objective.-To evaluate the behavior of GCTs and related entities with variable components of adenocarcinoma.Design.-We classified 74 cases of appendiceal tumors into 3 groups: group 1, GCTs or GCTs with less than 25% adenocarcinoma; group 2, GCTs with 25% to 50% adenocarcinoma; group 3, GCTs with more than 50% adenocarcinoma; and a comparison group of 68 adenocarcinomas without a GCT component (group 4). Welldifferentiated mucinous adenocarcinomas were excluded. Clinicopathologic features and follow-up were obtained from computerized medical records and the US Social Security Death Index.Results.-Of the 142 tumors studied, 23 tumors (16%)were classified as group 1; 27 (19%) as group 2; 24 (17%) as group 3; and 68 (48%) as group 4. Staging and survival differed significantly among these groups. Among 140 patients (99%) with available staging data, stages II, III, and IV were present in 87%, 4%, and 4% of patients in group 1 patients; 67%, 7%, and 22% of patients in group 2; 29%, 4%, and 67% of patients in group 3; and 19%, 6%, and 75% of patients in group 4, respectively (P ¼ .01). Mean (SD) overall survival was 83.8 (34.6), 60.6 (30.3), 45.6 (39.7), and 33.6 (27.6) months for groups 1, 2, 3, and 4, respectively (P ¼ .01). By multivariate analysis, only stage and tumor category were independent predictors of overall survival. Conclusion.-Our data highlight the importance of subclassifying the proportion of adenocarcinoma in appendiceal tumors with GCT morphology because that finding reflects disease stage and affects survival.

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Section: Commentsupporting

confidence: 93%

Section: Commentmentioning

confidence: 52%

Section: Commentmentioning

confidence: 99%

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Goblet Cell Carcinoid Tumor, Mixed Goblet Cell Carcinoid-Adenocarcinoma, and Adenocarcinoma of the Appendix: Comparison of Clinicopathologic Features and Prognosis

Taggart

Abraham²,

Overman³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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“…The most common clinical presentation is acute appendicitis [4,20,22] . However, Tang et al [17] reported abdominal pain and lower abdominal palpable mass in 50% patients, while acute appendicitis was the presenting feature in 44%.…”

Section: Clinical Presentationmentioning

confidence: 99%

Goblet cell carcinoid tumors of the appendix: An overview

Roy

Chetty²

2010

WJGO

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Goblet cell carcinoid is an enigmatic and rare tumor involving the appendix almost exclusively. Since its identification in 1969, understanding of this disease has evolved greatly, but issues regarding its histogenesis, nomenclature and management are still conjectural. The published English language literature from 1966 to 2009 was retrieved via PubMed and reviewed. Various other names have been used for this entity such as adenocarcinoid, mucinous carcinoid, crypt cell carcinoma, and mucin-producing neuroendocrine tumor, although none have been found to be completely satisfactory or universally accepted. The tumor is thought to arise from pluripotent intestinal epithelial crypt-base stem cells by dual neuroendocrine and mucinous differentiation. GCCs present in the fifth to sixth decade and show no definite sex predominance. The most common clinical presentation is acute appendicitis, followed by abdominal pain and a mass. Fifty percent of the female patients present with ovarian metastases. The histologic hallmark of this entity is the presence of clusters of goblet cells in the lamina propria or submucosa stain for various neuroendocrine markers, though the intensity is often patchy. Atypia is usually minimal, but carcinomatous growth patterns may be seen. These may be of signet ring cell type or poorly differentiated adenocarcinoma. Recently molecular studies have shown these tumors to lack the signatures of adenocarcinoma but they have some changes similar to that of ileal carcinoids (allelic loss of chromosome 11q, 16q and 18q). The natural history of GCC is intermediate between carcinoids and adenocarcinomas of the appendix. The 5-year overall survival is 76%. The most important prognostic factor is the stage of disease. Appendectomy and right hemicolectomy are the main modalities of treatment, followed by adjuvant chemotherapy in select cases. There is some debate about the surgical approach for these tumors, and a summary of published series and recommendations are provided.

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“…In cases with advanced peritoneal dissemination, cytoreductive surgery with ad juvant intraperitoneal chemotherapy may offer prolonged survival [35] . Adjuvant chemotherapy is usually not effective although it can be used in patients with obvious spread of the disease [36] . Chemotherapeutic protocols are the same as those used in the treatment of colorectal adenocarcinoma.…”

Section: Treatmentmentioning

confidence: 99%

Appendiceal neuroendocrine tumors: Recent insights and clinical implications

Grınıatsos

Michail²

2010

WJGO

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New insights emerged last decade that enriched our knowledge regarding the biological behavior of appendiceal neuroendocrine tumors (NETs), which range from totally benign tumors less than 1cm to goblet cell carcinomas which behave similarly to colorectal adenocarcinoma. The clinical implication of that knowledge reflected to surgical strategies which also vary from simple appendicectomy to radical abdominal procedures based on specific clinical and histological characteristics. Since the diagnosis is usually established post-appendicectomy, current recommendations focus on the early detection of: (1) the subgroup of patients who require further therapy; (2) the recurrence based on the chromogranin a plasma levels; and (3) other malignancies which are commonly developed in patients with appendiceal NETs.

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Surgical and Chemotherapy Treatment Outcomes of Goblet Cell Carcinoid: A Tertiary Cancer Center Experience

Cited by 116 publications

References 14 publications

Goblet Cell Carcinoid Tumor, Mixed Goblet Cell Carcinoid-Adenocarcinoma, and Adenocarcinoma of the Appendix: Comparison of Clinicopathologic Features and Prognosis

Goblet Cell Carcinoid Tumor, Mixed Goblet Cell Carcinoid-Adenocarcinoma, and Adenocarcinoma of the Appendix: Comparison of Clinicopathologic Features and Prognosis

Goblet cell carcinoid tumors of the appendix: An overview

Appendiceal neuroendocrine tumors: Recent insights and clinical implications

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