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appendiceal cancer

Mitsutake Yano, Tomomi Katoh, Tetsuya Hamaguchi, Eito Kozawa, Mei Hamada, Koji Nagata, Masanori Yasuda
BACKGROUND: Tumor-to-tumor metastasis (TTM) is a rare but well-documented phenomenon that is defined as metastasis in a histologically distinct tumor. Ovarian mature teratomas (OMTs) can coexist with various cancers by malignant transformation, which may make it difficult to distinguish these from TTM. Herein, we report a case of TTM from appendiceal adenocarcinoma to the OMT, mimicking the malignant transformation of OMT. CASE PRESENTATION: A 67-year-old Japanese woman underwent abdominal total hysterectomy and bilateral salpingo-oophorectomy for an ovarian tumor in another hospital...
August 14, 2019: Diagnostic Pathology
Jaimie Seawell, Jason D Sciarretta, Maranda Pahlkotter, Keely Muertos, Ayolola Onayemi, John M Davis
Cancer of the appendix is rare and is most commonly found incidentally on pathology after an appendectomy for uncomplicated appendicitis (UA). The medical management alternative with antibiotics and observation remains an ongoing debate. The purpose of our study was to develop modern epidemiological data for adult patients completing an appendectomy for UA secondary to an appendiceal neoplasm (AN). ACS-NSQIP database was queried (2005-2016) to identify patients completing an appendectomy. Cohorts of patients who were diagnosed with UA and an AN were included in the study...
July 1, 2019: American Surgeon
Daniel Solomon, Eliahu Bekhor, Natasha Leigh, Yash M Maniar, Linsay Totin, Margaret Hoftsedt, Samantha N Aycart, Jacquelyn Carr, Samuel Ballentine, Deepa R Magge, Benjamin J Golas, Reetesh K Pai, Alexandros D Polydorides, David L Bartlett, Daniel M Labow, Haroon A Choudry, Umut Sarpel
BACKGROUND: Low-grade appendiceal mucinous neoplasms (LAMNs) are tumors that often present with widespread mucin in the peritoneal cavity (pseudomyxoma peritonei [PMP]). Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective treatment, but no published recommendations exist regarding surveillance. METHODS: Data from prospective databases of patients who underwent CRS-HIPEC from 2001 to 2017 at two high-volume institutions were retrospectively analyzed...
August 5, 2019: Annals of Surgical Oncology
Toshiyuki Kitai, Kenya Yamanaka, Naoko Sugimoto, Osamu Inamoto
PURPOSE: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) is the active treatment for peritoneal carcinomatosis of appendiceal origin. However, surgical management is sometimes difficult in patients with a high-tumor burden. METHODS: A high-tumor burden was defined as a peritoneal cancer index (PCI) ≥ 28. Among 49 patients receiving CRS + HIPEC, 29 had a PCI ≥ 28. RESULTS: Complete cytoreduction (CC-0/1) was achieved in 20 of the 29 patients with a PCI ≥ 28 and in all 20 patients with a PCI < 28...
July 30, 2019: Surgery Today
John D. Spiliotis, Christos Iavazzo, Nikolaos D. Kopanakis, Athina Christopoulou
Objective: To analyse the kind of ovarian cancer relapse by separating residual from recurrent disease and correlating them with patients’ survival. Material and methods: Retrospective study of 200 women with ovarian carcinoma relapse during the period 2005-2017. Results: The main sites of residual disease included great omentum, epiploic appendices, liver round ligament, gallbladder, cervical/vaginal stump. Median survival for women with residual disease treated with cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC)+ systemic chemotherapy was 38 months compared to the control group which reached 23,8 months...
July 31, 2019: Journal of the Turkish German Gynecological Association
Ryan W Day, Yu-Hui Chang, Chee-Chee Stucky, Richard Gray, Barbara Pockaj, Nabil Wasif
BACKGROUND: Histologic subtypes of appendiceal cancer vary in their propensity for metastases to regional lymph nodes (LN). A predictive model would help direct subsequent surgical therapy. METHODS: The National Cancer Database was queried for patients with appendiceal cancer undergoing surgery between 1998 and 2012. Multivariable logistic regression was used to develop a predictive model of LN metastases which was internally validated using Brier score and Area under the Curve (AUC)...
July 29, 2019: Annals of Surgery
Andrew M Blakely, Mustafa Raoof, Philip H G Ituarte, Yuman Fong, Gagandeep Singh, Byrne Lee
BACKGROUND: Appendiceal neuroendocrine tumors (NETs) are incidentally found in up to 1% of appendectomy specimens. The association of lymphovascular invasion (LVI) with risk of regional lymph node involvement is unclear. METHODS: From the National Cancer Database, 2004-2015, this study identified patients who had tumors 2 cm or smaller with one or more lymph nodes (LNs) pathologically evaluated. The histology was defined as typical, goblet cell, or composite NETs...
July 29, 2019: Annals of Surgical Oncology
Laith Numan, Samia Asif, Omar K Abughanimeh
Breast cancer is the most common cancer in women; it is well-known to metastasize to lymph nodes, lungs, liver, brain, and bones. However, luminal gastrointestinal metastasis is rare, especially to the appendix. Herein, we report a case where cancer metastasized to the ileum and appendix, causing acute appendicitis and small bowel obstruction. This is a 44-year-old female with a history of stage IV metastatic breast cancer to bones, lungs, and ovaries, presented with acute abdominal pain for one day. Her abdomen was soft, distended with generalized tenderness...
May 21, 2019: Curēus
Aditi Bhatt, Yutaka Yonemura, Nazim Benzerdjeb, Sanket Mehta, Suniti Mishra, Loma Parikh, Praveen Kammar, Mita Y Shah, Aruna Prabhu, Sakina Shaikh, Mahesh D Patel, Sylvie Isaac, Olivier Glehen
BACKGROUND AND AIM: The grade/histological subtype is one of the most important prognostic markers in patients undergoing cytoreductive surgery (CRS). Our aim was to study other potential prognostic information that can be derived from the pathological evaluation of CRS specimens and provide a broad outline for evaluation of these. METHODS: This prospective study (July to December 2018) included all patients undergoing cytoreductive surgery (CRS). A protocol for pathological evaluation was laid down which was based on existing practices at the participating centers and included evaluation of the pathological PCI, regional node involvement, response to chemotherapy, morphology of peritoneal metastases (PM) and distribution in the peritoneal cavity...
July 16, 2019: European Journal of Surgical Oncology
Ragavan V Siddharthan, Raphael M Byrne, Elizabeth Dewey, Robert G Martindale, Erin W Gilbert, Vassiliki L Tsikitis
BACKGROUND: The misdiagnosis of appendiceal cancer as inflammatory appendicitis is becoming of greater clinical concern because of the rise of nonoperative management especially in the elder population. To quantify this rate of misdiagnosis, we retrospectively reviewed SEER-Medicare data. METHODS: The SEER-Medicare database was reviewed from 2000 to 2014. We identified patients older than 65 years old who were diagnosed with appendiceal cancer and then cross-referenced them for a diagnosis of inflammatory appendicitis...
July 16, 2019: Journal of Surgical Oncology
Pooja Lal, Mohannad Abou Saleh, George Khoudari, Mohamed M Gad, Emad Mansoor, Gerard Isenberg, Gregory S Cooper
BACKGROUND AND AIMS: Prior studies have shown that about 90% of all carcinoid tumors occur in the GI tract. However, epidemiological studies of these tumors have been limited by small sample size. Our aim was to obtain a more robust epidemiologic survey of large bowel carcinoids (LBC), using population-based data in order to more accurately identify risk factors for these tumors. METHODS: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems...
July 12, 2019: Digestive Diseases and Sciences
Manuela Robella, Marco Vaira, Monica Argenziano, Rita Spagnolo, Roberta Cavalli, Alice Borsano, Sergio Gentilli, Michele De Simone
Background: Peritoneal carcinomatosis is a common metastatic pattern in ovarian, gastric, colorectal, and appendiceal cancer; systemic chemotherapy is the current standard of care for peritoneal metastatic disease; however, in a subset of patients its beneficial effect remains questionable. More effective perioperative chemotherapy is needed. Materials and methods: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment that applies chemotherapeutic drugs into the peritoneal cavity as an aerosol under pressure...
2019: Frontiers in Pharmacology
Carlos Guzman, Sowmya Boddhula, Narmadha Panneerselvam, Chetan Dodhia, Nicholas J Hellenthal, Daphne Monie, Jose Raul Monzon, Theodor Kaufman
BACKGROUND: Guidelines recommend colectomy for appendiceal carcinoid tumors larger than 2 cm, but physicians debate whether colectomy would be beneficial in treating smaller tumors. We sought to determine when colectomy confers a survival advantage over appendectomy. METHODS: Appendiceal carcinoid patients in the US Surveillance, Epidemiology, and End Results (SEER) database (1988-2011) were stratified by age group, gender, TNM stage, tumor grade, and race. Kaplan-Meier and logistic regression analyses relating grade, stage, and receipt of colectomy to overall and cancer-specific survival were performed...
July 3, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Pamela Lu, Justin C McCarty, Adam C Fields, Katherine C Lee, Stuart R Lipsitz, Joel E Goldberg, Jennifer Irani, Ronald Bleday, Nelya Melnitchouk
BACKGROUND AND OBJECTIVES: Management practices for acute appendicitis are changing. In cases of nonoperative treatment, the risk of missed or delayed diagnosis of malignancy should be considered. We aimed to identify predictors associated with appendiceal cancer diagnosis after appendectomy for acute appendicitis. MATERIALS AND METHODS: This retrospective cohort study was performed using the National Surgical Quality Improvement Program (NSQIP) appendectomy-targeted data set from 2016 to 2017...
July 3, 2019: Journal of Surgical Oncology
Pamela Lu, Adam C Fields, Jeffrey A Meyerhardt, Jennifer S Davids, Galyna Shabat, Ronald Bleday, Joel E Goldberg, Garrett M Nash, Nelya Melnitchouk
BACKGROUND: Appendiceal cancer is a rare malignancy that exhibits a wide range of histology and treatment response. Given the rarity and heterogeneous nature of the disease, it has been difficult to define optimal treatment strategies. Our goal is to examine the association between use of systemic chemotherapy and survival in patients with metastatic low-grade mucinous appendiceal adenocarcinoma. METHODS: The National Cancer Database (2004-2015) was queried, and patients with mucinous, grade 1, stage IV appendiceal adenocarcinoma were identified...
June 24, 2019: Journal of Surgical Oncology
Natasha L Leigh, Daniel Solomon, Daniela Feingold, Deepa R Magge, Benjamin J Golas, Umut Sarpel, Daniel M Labow
BACKGROUND: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an aggressive locoregional treatment for peritoneal carcinomatosis (PC). Studies demonstrate improved perioperative and oncologic outcomes at high-volume centers. METHODS: This study retrospectively analyzed all patients with PC from various malignancies who underwent attempted CRS/HIPEC at the authors' institution from 2007 to 2017. Clinicopathologic, perioperative, and oncologic outcomes of early (2007-2012) and late (2012-2017) experience were compared, and multivariate analyses for factors predictive of perioperative and oncologic outcomes were performed...
June 20, 2019: Annals of Surgical Oncology
Joel M Baumgartner, Rebecca Marmor, Athena Hsu, Jula Veerapong, Kaitlyn J Kelly, Andrew M Lowy
BACKGROUND: Patients with peritoneal metastases from appendiceal cancer are at high risk of malignant bowel obstruction (MBO), which is associated with significant morbidity and mortality. There are no definitive treatment guidelines regarding operative intervention for MBO. We sought to evaluate the efficacy and safety of operative intervention in this population. METHODS: We identified patients with peritoneal metastases from appendiceal cancer who underwent surgery for MBO at our institution between 2011 and 2018...
June 12, 2019: Annals of Surgical Oncology
Ryan J Ellis, Cary Jo R Schlick, Anthony D Yang, Emma L Barber, Karl Y Bilimoria, Ryan P Merkow
INTRODUCTION: Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) is an effective treatment option for selected patients with peritoneal metastases (PM), but national utilization patterns are poorly understood. The objectives of this study were to (1) describe population-based trends in national utilization of CRS/IPC; (2) define the most common indications for the procedure; and (3) characterize the types of hospitals performing the procedure. METHODS: The National Inpatient Sample (NIS) was used to identify patients from 2006 to 2015 who underwent CRS/IPC, and to calculate national estimates of procedural frequency and oncologic indication...
June 11, 2019: Annals of Surgical Oncology
Toshinori Sueda, Kohei Murata, Takashi Takeda, Yoshinori Kagawa, Junichi Hasegawa, Takamichi Komori, Shingo Noura, Kimimasa Ikeda, Masaki Tsujie, Masayuki Ohue, Hirofumi Ota, Masakazu Ikenaga, Taishi Hata, Chu Matsuda, Tsunekazu Mizushima, Hirofumi Yamamoto, Mitsugu Sekimoto, Riichiro Nezu, Masaki Mori, Yuichiro Doki
Aim: Appendiceal mucinous neoplasms are rare, and thus the literature is sparse with regard to histological types, staging, and prognosis. In particular, it is unclear how long-term outcome may differ between mucinous adenocarcinomas and other adenocarcinomas. In the present study, we aimed to investigate the histological types and stages of appendiceal neoplasms, and to evaluate the prognostic impacts of these factors in patients with mucinous adenocarcinomas and non-mucinous adenocarcinomas...
May 2019: Annals of Gastroenterological Surgery
Haroon A Choudry, Reetesh K Pai, Anoosh Parimi, Heather L Jones, James F Pingpank, Steven S Ahrendt, Matthew P Holtzman, David L Bartlett
BACKGROUND: Diagnostic terminology and grading of primary appendiceal mucinous neoplasms lacks uniformity. We sought to identify discordance in pathologic reporting by reviewing pathology slides for cases referred to our institution. METHODS: Using guidelines from Peritoneal Surface Oncology Group International (PSOGI) and American Joint Committee on Cancer 8th edition (AJCC8), we compared diagnostic terminology/grading of primary appendiceal mucinous neoplasms (n = 115) between pathology reports from referring institutions and review of slides by pathologists at our high-volume institution...
May 20, 2019: Annals of Surgical Oncology
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