Introduction: A practical staging classification that has prognostic significance in mucinous appendiceal neoplasms represents an unmet need in oncology. The purpose of this study is to present a second edition of the...Introduction: A practical staging classification that has prognostic significance in mucinous appendiceal neoplasms represents an unmet need in oncology. The purpose of this study is to present a second edition of the PSDSS in mucinous appendiceal neoplasms with or without peritoneal dissemination based on the AJCC/TNM 8<sup>th</sup> edition. Materials and Methods: We analyzed 229 patients based on the AJCC/TNM 8<sup>th</sup> edition incorporating G (grade) and E (extent of disease). The impact of these 5 clinicopathological variables (T, N, M, G, E) is scored as stages 0 to IV and is reported as the Esquivel Peritoneal Surface Disease Severity Score (E-PSDSS). Results: One hundred and seventy-three patients underwent cytoreductive surgery (CRS) and HIPEC. There were 30 (13.1%), 56 (24.4%), 48 (20.9%), 20 (8.7%) and 75 (32.7%) patients with E-PSDSS 0, I, II, III, and IV, respectively. Five-year overall survival was 100%, 100%, 84.46%, 52.29% and 12.92% for E-PSDSS 0, I, II, III and IV, respectively (p Conclusion: The E-PSDSS combines specimen examination and reporting according to the College of American Pathologists with the pTNM requirements from the AJCC staging manual. It represents an important prognostic indicator in patients with mucinous appendiceal neoplasms.展开更多
Neoplasms of the vermiform appendix represent 1% of all gastrointestinal tumors, with epithelial and neuroendocrine histological subtypes being the most frequent. When two or more neoplasms with different components o...Neoplasms of the vermiform appendix represent 1% of all gastrointestinal tumors, with epithelial and neuroendocrine histological subtypes being the most frequent. When two or more neoplasms with different components originate synchronically in the appendix with clear margin between them, it is called a collision tumor, with exceptional cases being reported in literature. The purpose is to present two new cases of collision tumors of the appendix and perform a review of the published literature. Two cases of an 82-year-old female and a 41-year-old male with collision tumors of the vermiform appendix are presented, with clinical presentation, radiological evaluation and surgical treatment exposed. Our results are compared with other published reports. In accordance with the other reported cases, both patients presented with low-grade appendiceal mucinous neoplasm (LAMN). Female patient with synchronous goblet cell carcinoma managed with a completion right colectomy and Hyperthermic intraperitoneal chemotherapy (HIPEC) and the other patient with well-differentiated neuroendocrine (NET) tumor managed with laparoscopic appendectomy without adjuvant treatment. Since very few cases have been reported, no diagnostic and therapeutic consensus and guidelines exist up to date. We agree that local, regional, and systemic therapies should be chosen according to the tumor that represents the worst prognosis.展开更多
文摘Introduction: A practical staging classification that has prognostic significance in mucinous appendiceal neoplasms represents an unmet need in oncology. The purpose of this study is to present a second edition of the PSDSS in mucinous appendiceal neoplasms with or without peritoneal dissemination based on the AJCC/TNM 8<sup>th</sup> edition. Materials and Methods: We analyzed 229 patients based on the AJCC/TNM 8<sup>th</sup> edition incorporating G (grade) and E (extent of disease). The impact of these 5 clinicopathological variables (T, N, M, G, E) is scored as stages 0 to IV and is reported as the Esquivel Peritoneal Surface Disease Severity Score (E-PSDSS). Results: One hundred and seventy-three patients underwent cytoreductive surgery (CRS) and HIPEC. There were 30 (13.1%), 56 (24.4%), 48 (20.9%), 20 (8.7%) and 75 (32.7%) patients with E-PSDSS 0, I, II, III, and IV, respectively. Five-year overall survival was 100%, 100%, 84.46%, 52.29% and 12.92% for E-PSDSS 0, I, II, III and IV, respectively (p Conclusion: The E-PSDSS combines specimen examination and reporting according to the College of American Pathologists with the pTNM requirements from the AJCC staging manual. It represents an important prognostic indicator in patients with mucinous appendiceal neoplasms.
文摘Neoplasms of the vermiform appendix represent 1% of all gastrointestinal tumors, with epithelial and neuroendocrine histological subtypes being the most frequent. When two or more neoplasms with different components originate synchronically in the appendix with clear margin between them, it is called a collision tumor, with exceptional cases being reported in literature. The purpose is to present two new cases of collision tumors of the appendix and perform a review of the published literature. Two cases of an 82-year-old female and a 41-year-old male with collision tumors of the vermiform appendix are presented, with clinical presentation, radiological evaluation and surgical treatment exposed. Our results are compared with other published reports. In accordance with the other reported cases, both patients presented with low-grade appendiceal mucinous neoplasm (LAMN). Female patient with synchronous goblet cell carcinoma managed with a completion right colectomy and Hyperthermic intraperitoneal chemotherapy (HIPEC) and the other patient with well-differentiated neuroendocrine (NET) tumor managed with laparoscopic appendectomy without adjuvant treatment. Since very few cases have been reported, no diagnostic and therapeutic consensus and guidelines exist up to date. We agree that local, regional, and systemic therapies should be chosen according to the tumor that represents the worst prognosis.
