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ANZ Journal of Surgery Mar 2022
Topics: Appendiceal Neoplasms; Appendix; Humans; Neoplasms, Glandular and Epithelial
PubMed: 34324784
DOI: 10.1111/ans.17107 -
The Oncologist Sep 2017Appendiceal mucinous neoplasms (AMNs) are a rare and heterogeneous disease for which clinical management is challenging. We aim to review the literature regarding... (Review)
Review
OBJECTIVE
Appendiceal mucinous neoplasms (AMNs) are a rare and heterogeneous disease for which clinical management is challenging. We aim to review the literature regarding modalities of treatment to guide the management of AMNs.
METHODS AND REVIEW CRITERIA
We conducted a PubMed search in February 2016 for English-language publications, using the terms "appendiceal," "appendix," "carcinoma," "cancer," "mucinous," "treatment," "genes," "target," "genomic," and terms listed in the articles' subheadings. Published reports and abstracts from the American Society of Clinical Oncology meetings were also searched.
RESULTS
In this review, we summarize current data and controversies in AMN classification, clinical presentation, molecular alterations, treatment outcomes with regard to cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and the role of systemic chemotherapy.
CONCLUSION
Appendiceal mucinous neoplasms are a heterogeneous group of tumors with a rising incidence. Treatment is based on stage and histology. Low-grade tumors are treated surgically with resection of the primary site in early stage disease, or peritoneal debulking and HIPEC in patients with advanced stage disease. Treatment of high-grade tumors requires further prospective trials, and options include debulking surgery and HIPEC with or without preoperative chemotherapy. Trials evaluating novel therapies based on the molecular profiling of AMN tumors are needed to evaluate therapeutic options in patients who are not surgical candidates.
IMPLICATIONS FOR PRACTICE
This review provides a reference to guide gastroenterologists, pathologists, surgeons, and oncologists in the management of appendiceal mucinous neoplasms (AMNs), a rare and heterogeneous disease with no consensus on histologic classification or guidelines for treatment algorithms. This review summarizes all AMN classifications and proposes a treatment algorithm based on stage and histology of disease.
Topics: Adenocarcinoma, Mucinous; Antineoplastic Combined Chemotherapy Protocols; Appendiceal Neoplasms; Appendix; Cytoreduction Surgical Procedures; Humans; Hyperthermia, Induced; Neoplasm Staging; Practice Guidelines as Topic; Rare Diseases; Treatment Outcome
PubMed: 28663356
DOI: 10.1634/theoncologist.2017-0081 -
Clinical Journal of Oncology Nursing Aug 2020Appendiceal mucinous neoplasms (AMNs) are a rare and complex spectrum of disease involving a mucinous tumor within the appendix, which can range from benign to... (Review)
Review
BACKGROUND
Appendiceal mucinous neoplasms (AMNs) are a rare and complex spectrum of disease involving a mucinous tumor within the appendix, which can range from benign to malignant. If not limited to the appendix, the mucinous tumor can spread diffusely throughout the peritoneum.
OBJECTIVES
Because of the low incidence of AMN, this study describes the diagnosis and treatment process for this disease, which is not well known to most care providers.
METHODS
An extensive analysis of the current literature, including incidence, diagnosis, and surgical treatment, was performed. A review of the pre- and postoperative needs for patients undergoing surgery was also conducted.
FINDINGS
There is minimal information in the nursing literature about AMN and the complexity of surgical management. Nurses play an important role in caring for these patients and their unique needs both before and after surgery.
Topics: Appendiceal Neoplasms; Appendix; Education, Nursing; Humans; Peritoneal Neoplasms; Pseudomyxoma Peritonei
PubMed: 32678367
DOI: 10.1188/20.CJON.409-414 -
European Journal of Surgical Oncology :... Jan 2021Pseudomyxoma Peritonei (PMP) is a rare peritoneal malignancy, most commonly originating from a perforated epithelial tumour of the appendix. Given its rarity, randomized... (Review)
Review
Pseudomyxoma Peritonei (PMP) is a rare peritoneal malignancy, most commonly originating from a perforated epithelial tumour of the appendix. Given its rarity, randomized controlled trials on treatment strategies are lacking, nor likely to be performed in the foreseeable future. However, many questions regarding the management of appendiceal tumours, especially when accompanied by PMP, remain unanswered. This consensus statement was initiated by members of the Peritoneal Surface Oncology Group International (PSOGI) Executive Committee as part of a global advisory role in the management of uncommon peritoneal malignancies. The manuscript concerns an overview and analysis of the literature on mucinous appendiceal tumours with, or without, PMP. Recommendations are provided based on three Delphi voting rounds with GRADE-based questions amongst a panel of 80 worldwide PMP experts.
Topics: Appendiceal Neoplasms; Consensus; Delphi Technique; Humans; Neoplasm Grading; Peritoneal Neoplasms; Pseudomyxoma Peritonei; Terminology as Topic
PubMed: 32199769
DOI: 10.1016/j.ejso.2020.02.012 -
The American Journal of Surgical... Jan 2016Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and...
A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia: The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process.
Pseudomyxoma peritonei (PMP) is a complex disease with unique biological behavior that usually arises from appendiceal mucinous neoplasia. The classification of PMP and its primary appendiceal neoplasia is contentious, and an international modified Delphi consensus process was instigated to address terminology and definitions. A classification of mucinous appendiceal neoplasia was developed, and it was agreed that "mucinous adenocarcinoma" should be reserved for lesions with infiltrative invasion. The term "low-grade appendiceal mucinous neoplasm" was supported and it was agreed that "cystadenoma" should no longer be recommended. A new term of "high-grade appendiceal mucinous neoplasm" was proposed for lesions without infiltrative invasion but with high-grade cytologic atypia. Serrated polyp with or without dysplasia was preferred for tumors with serrated features confined to the mucosa with an intact muscularis mucosae. Consensus was achieved on the pathologic classification of PMP, defined as the intraperitoneal accumulation of mucus due to mucinous neoplasia characterized by the redistribution phenomenon. Three categories of PMP were agreed-low grade, high grade, and high grade with signet ring cells. Acellular mucin should be classified separately. It was agreed that low-grade and high-grade mucinous carcinoma peritonei should be considered synonymous with disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis, respectively. A checklist for the pathologic reporting of PMP and appendiceal mucinous neoplasms was also developed. By adopting the classifications and definitions that were agreed, different centers will be able to use uniform terminology that will allow meaningful comparison of their results.
Topics: Appendiceal Neoplasms; Biomarkers, Tumor; Biopsy; Checklist; Consensus; Delphi Technique; Humans; Lymphatic Metastasis; Mucins; Mucus; Neoplasm Grading; Neoplasm Invasiveness; Neoplasms, Cystic, Mucinous, and Serous; Peritoneal Neoplasms; Predictive Value of Tests; Pseudomyxoma Peritonei; Terminology as Topic
PubMed: 26492181
DOI: 10.1097/PAS.0000000000000535 -
Clinics and Research in Hepatology and... May 2021
Topics: Adenocarcinoma, Mucinous; Appendiceal Neoplasms; Humans
PubMed: 33588100
DOI: 10.1016/j.clinre.2021.101647 -
The Surgeon : Journal of the Royal... Dec 2021Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually, recent studies show an alarming number of appendiceal neoplasms following interval appendectomy. The aim of this study is to evaluate the prevalence of appendiceal neoplasms and their histological types after interval appendectomy for complicated appendicitis in adults.
METHODS
A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement. Studies reporting appendiceal neoplasm rates after interval appendectomy and histopathological characteristics were included. The most recent World Health Organization (WHO) classification of malignant tumours was considered. A pooled prevalence analysis for both prevalence and pathology was performed.
RESULTS
A total of eight studies was included: seven retrospective series and one randomized controlled trial. The pooled prevalence of neoplasms after interval appendectomy was 11% (95% CI 7-15; I = 37.5%, p = 0.13). Appendiceal mucinous neoplasms occurred in 43% (95% CI 19-68), adenocarcinoma in 29% (95% CI 6-51), appendiceal neuroendocrine neoplasm in 21% (95% CI 6-36), globet cell carcinoma in 13% (95% CI -2-28), adenoma or serrated lesions in 20% (95% CI -0-41) of cases.
CONCLUSION
The risk of appendiceal neoplasm in patients treated with interval appendectomy for complicated appendicitis is 11%; mucinous neoplasm is the most common histopathological type. Further studies should investigate this association in order to clarify the biological pathway and clinical implications.
Topics: Adenocarcinoma; Appendectomy; Appendiceal Neoplasms; Appendicitis; Humans; Randomized Controlled Trials as Topic; Retrospective Studies
PubMed: 33640282
DOI: 10.1016/j.surge.2021.01.010 -
Acta Gastro-enterologica Belgica 2020Primary appendiceal cancer is rare and most commonly found incidentally on a surgical specimen after appendectomy for acute appendicitis. This small organ gives rise to... (Review)
Review
Primary appendiceal cancer is rare and most commonly found incidentally on a surgical specimen after appendectomy for acute appendicitis. This small organ gives rise to different subtypes which are histological and biological distinct. Historically the classification of these tumors has been confusing because of the different nomenclature that is used. This review has broadly classified them into four subgroups: colonic-type adenocarcinoma, mucinous neoplasm, goblet cell carcinoma and neuroendocrine neoplasm. Signet ring cells is not considered as a distinct subgroup but as a histologic feature that can be present in colonic-type adenocarcinoma and mucinous neoplasms. As staging and management of appendiceal tumors depend on these subtypes, an adequate classification of them is important. This review aimed to give an overview of the epidemiology, grading and staging, management and prognosis of these neoplasms. Despite its rarety, specific staging systems and treatment guidelines exist for some subtypes. For other subtypes staging systems and management is extrapolised from colorectal cancer because of the lack of randomised, prospective trials.
Topics: Appendectomy; Appendiceal Neoplasms; Appendicitis; Colorectal Neoplasms; Humans; Prospective Studies
PubMed: 33094592
DOI: No ID Found -
Journal of Surgical Oncology Jun 2023Appendiceal neoplasms (ANs) are a diverse group of pathologies that range from benign to malignant with widely varying prognoses. This article serves as an overview of... (Review)
Review
Appendiceal neoplasms (ANs) are a diverse group of pathologies that range from benign to malignant with widely varying prognoses. This article serves as an overview of the practical approach to evaluating and managing a patient with AN by reviewing the current literature and guidelines to provide a framework for the management of these nuanced pathologies.
Topics: Humans; Appendiceal Neoplasms
PubMed: 37222692
DOI: 10.1002/jso.27304 -
International Journal of Colorectal... Jan 2019Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of...
PURPOSE
Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of uncomplicated acute appendicitis has shown promising results. The data on appendiceal tumor incidence and presentation among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. Objective was to assess appendiceal tumor incidence and tumor association to appendicitis in patients with uncomplicated and complicated acute appendicitis.
METHODS
This nationwide population-based registry study was conducted from 2007 to 2013. The Finnish Cancer Registry and the National Institute for Health Registry were used to combine data on all appendiceal tumors and acute appendicitis diagnosis with medical reports evaluated at eight study hospitals.
RESULTS
Altogether, 840 appendiceal tumors were identified, and out of these, 504 patient reports were reviewed, including 472 patients in this study. Tumor was diagnosed at appendectomy for suspected acute appendicitis in 276 patients (58%). In the whole study, histologically acute appendicitis and tumor were both present in 53% (n = 250), and out of these, 41% (n = 102) were complicated and 59% (n = 148) uncomplicated acute appendicitis. The associated tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated cases (3.24% vs. 0.87%, p < 0.001). Overall tumor prevalence among acute appendicitis patients was 1.24%.
CONCLUSIONS
Appendiceal tumor prevalence in acute appendicitis was low. Tumor risk was significantly higher in complicated acute appendicitis compared with uncomplicated acute appendicitis. The risk of missed appendiceal tumors related to antibiotic therapy of uncomplicated acute appendicitis is very low.
Topics: Acute Disease; Appendiceal Neoplasms; Appendicitis; Female; Finland; Humans; Male; Middle Aged; Risk Factors
PubMed: 30242478
DOI: 10.1007/s00384-018-3156-x