[Adenocarcinoma of the appendix. A multicenter study from AURC]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Primary adenocarcinoma of the appendix is a rare malignancy.
• Preoperative diagnosis is challenging, often leading to delayed treatment.

Purpose of the Study:

• To review outcomes for patients with primary appendiceal adenocarcinoma.
• To evaluate the impact of surgical approach on survival and recurrence.

Main Methods:

• Collective review of 32 patients with primary adenocarcinoma of the appendix.
• Analysis of diagnostic accuracy, surgical interventions (appendectomy vs. right hemicolectomy), and patient outcomes.
• Correlation of survival with tumor histology, stage, and treatment modality.

Main Results:

• Appendiceal adenocarcinoma was rarely suspected preoperatively; 50% of tumors were identified incidentally during surgery for suspected appendicitis.
• The 5-year survival rate was 46%. Survival correlated with tumor spread, not histology.
• Right hemicolectomy significantly improved survival and decreased recurrence risk compared to appendectomy alone.
• For pseudomyxoma peritonei, repeated laparotomy with mucinous material resection achieved long-term survival.

Conclusions:

• Right hemicolectomy offers superior outcomes for appendiceal adenocarcinoma compared to appendectomy alone.
• Surgical approach and extent of disease are critical prognostic factors.
• Aggressive management, including repeated debulking for pseudomyxoma peritonei, can lead to long-term survival.