[Chemotherapeutic Strategy for Metastatic or Recurrent Appendiceal Adenocarcinoma]

Appendiceal adenocarcinoma(AA), a rare cancer, has been treated as right-sided colon cancer in accordance with colorectal cancer treatment guidelines. However, AA has distinct characteristics compared to colorectal cancer, such as a higher prevalence of mucinous histology and a tendency for peritoneal metastasis. In addition, there are many cases where the histological grade does not correlate with disease progression, and differences in treatment response and prognosis have been reported depending on genetic mutation subtypes. In terms of chemotherapy, in addition to oxaliplatin-based regimens, there have been reports on the efficacy of molecular targeted therapies and immunotherapies. In our multicenter observational study, AA patients with multiple factors such as poor PS, high tumor burden, and moderate to massive ascites had significantly poor prognosis compared to those without. In the future, we need to develop novel therapeutic strategies based on genetic status and tumor biological characteristics.