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Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours

Audrius Dulskas1, Tomas Poskus2, Eligijus Poskus2

  • 1Department of Abdominal and Oncological Surgery, National Cancer Institute, Vilnius, Lithuania.

Visceral Medicine
|June 12, 2018
PubMed
Abstract

Insights

Appendiceal mucinous tumors (AMT) are rare, but outcomes are good, even with spread. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) offer excellent prognosis for peritoneal pseudomyxoma (PMP).

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Oncology

Background:

  • Appendiceal mucinous tumors (AMT) represent a rare clinical entity.
  • Evaluating patient characteristics and long-term outcomes for appendiceal mucinous adenomas and peritoneal pseudomyxoma (PMP) is crucial.

Purpose of the Study:

  • To assess preoperative and postoperative factors influencing outcomes in AMT patients.
  • To determine the long-term prognosis for patients with appendiceal mucinous adenomas and PMP.

Main Methods:

  • A cohort of 25 patients diagnosed with AMT between 2003 and 2013 was analyzed.
  • Tumor recurrence and PMP development were diagnosed through clinical evaluation, imaging, and biopsy.
  • Survival rates were calculated using the Kaplan-Meier method.

Main Results:

  • Histopathology revealed adenoma in 48% of patients, with low-grade PMP in one case (4%).
  • Appendiceal mucinous adenocarcinoma (AMCa) was diagnosed in 44% of patients, with PMP in 28% and high-grade AMCa in 8%.
  • Five-year survival was 100% for adenomas and 62% for PMP patients; 2 PMP patients did not receive CRS ± HIPEC due to comorbidities.

Conclusions:

  • Appendiceal mucinous tumors (AMT) are rare but generally have favorable outcomes, even in advanced stages.
  • Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) represent the gold standard for PMP treatment, yielding excellent prognoses.
  • While outcomes are promising, further improvements in treatment strategies are anticipated.
Keywords:
AppendectomyCytoreductive surgeryHyperthermic intraperitoneal chemotherapy, HIPECMucinous appendiceal neoplasmMucocelePseudomyxoma peritonei

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