Predictors of recurrence in nonmetastatic appendiceal epithelial cancers: An updated single-center experience over 25 years Journal Article

   


Authors: Aguirre, N.; Chung, S. K.; Foote, M. B.; Shia, J.; Vakiani, E.; Gowda, T.; Paty, P. B.; Weiser, M. R.; Garcia-Aguilar, J.; Karagkounis, G.; Cercek, A.; Nash, G. M.
Article Title: Predictors of recurrence in nonmetastatic appendiceal epithelial cancers: An updated single-center experience over 25 years
Abstract: Background: Appendiceal epithelial tumors are rare and encompass a broad set of adenocarcinoma histologies, including mucinous (mAC), colonic-type (cAC), and goblet cell (GCA) adenocarcinomas. It has previously been reported that nodal disease predicted recurrence in patients with nonmetastatic appendiceal adenocarcinomas, supporting diagnostic laparoscopy with right hemicolectomy for staging and assessment for risk of recurrence. In this update, we sought to identify predictors of nodal disease on initial diagnostic pathology in nonmetastatic adenocarcinomas. Methods: Patients with nonmetastatic appendiceal adenocarcinoma at a single institution from 1994 to 2020 were included. Clinicopathologic characteristics that predict recurrence and lymph node metastasis were analyzed. Workup included staging laparoscopy with right hemicolectomy, seriel imaging and biochemical monitoring. Results: A total of 147 patients with mAC (18%), cAC (22%), and GCAs (59%) were included. After median follow-up of 53 months, 23 (16%) patients recurred, most commonly in the peritoneal cavity (17/23, 74%). Recurrence rates were higher among node-positive patients (59% vs. 5%, P < 0.001). Nodal disease was more common in mAC (27%) and cAC (37%) than in GCA (11%); however, adenocarcinoma grade was not associated with nodal involvement. Conclusions: Nodal metastasis was more common in mAC and cAC compared with GCA and was the only significant predictor of recurrence in appendix cancer. © Society of Surgical Oncology 2024.
Keywords: adult; human tissue; aged; cancer surgery; major clinical study; overall survival; cancer recurrence; fluorouracil; adjuvant therapy; cancer staging; recurrence risk; follow up; lymph node metastasis; laparoscopy; irinotecan; appendectomy; oxaliplatin; floxuridine; hemicolectomy; recurrence free survival; acute appendicitis; peritoneal cavity; human; male; female; article; multidisciplinary team; appendiceal adenocarcinoma
Journal Title: Annals of Surgical Oncology
Volume: 32
Issue: 2
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2025-02-01
Start Page: 695
End Page: 702
Language: English
DOI: 10.1245/s10434-024-16366-7
PUBMED: 39604747
PROVIDER: scopus
PMCID: PMC11813631
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85209759639&doi=10.1245%2fs10434-024-16366-7&partnerID=40&md5=44b287f6e135fb6e3dd0233ce55ec2b9
Notes: Article -- Source: Scopus
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MSK Authors
  1. Philip B Paty
    501 Paty
  2. Andrea Cercek Hanjis
    355 Cercek Hanjis
  3. Jinru Shia
    720 Shia
  4. Martin R Weiser
    540 Weiser
  5. Garrett Nash
    267 Nash
  6. Efsevia Vakiani
    265 Vakiani
  7. Julio Garcia Aguilar
    354 Garcia Aguilar
  8. Michael Bonner Foote
    46 Foote
  9. Sebastian King Yin Chung
    13 Chung
  10. Nicole Aguirre
    9 Aguirre
  11. Georgios Karagkounis
    18 Karagkounis
  12. Tina Gowda
    2 Gowda
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