Appendiceal adenocarcinoma: long-term outcomes after surgical therapy.
OBJECTIVE
Appendiceal adenocarcinomas are very rare. We analyzed contemporary outcomes associated with surgical therapies for these malignancies.


METHODS
Retrospective outcomes for patients treated at a tertiary academic medical center from 1981 through 2001 were analyzed.


RESULTS
A total of 36 patients (22 females (61 percent) mean age, 52 years) with appendiceal adenocarcinoma were treated. Eighty-eight percent of patients presented with symptoms of acute appendicitis. Eighteen (50 percent) patients underwent curative resection (7 primary right hemicolectomies, 10 appendectomies + subsequent right hemicolectomy, and 1 appendectomy alone). Mean length of follow-up was 55 months. Overall five-year survival rate was 46 percent. The five-year survival rate after curative resection was 61 percent and after palliative surgery was 32 percent ( P < 0.05). Among patients who underwent curative resection, factors associated with improved five-year survival rates included histologic type (79 vs. 32 percent for colonic vs. mucinous types, respectively; P < 0.05), T stage (75 vs. 47 percent for T1 and 2 vs. T3 and 4, respectively; P < 0.05), and tumor grade (100 vs. 46 percent for well-differentiated tumors vs. moderately or poorly differentiated tumors, respectively; P < 0.05).


CONCLUSIONS
Patients undergoing surgery for appendiceal adenocarcinoma can be stratified according to prognostic variables. The role of adjuvant therapies for patients with poor prognostic factors needs to be evaluated in a multi-institutional setting.
Ito
Hiromichi
H
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Osteen
Robert T
RT
Bleday
Ronald
R
Zinner
Michael J
MJ
Ashley
Stanley W
SW
Whang
Edward E
EE
D015746:Abdominal Pain / Q000209:etiology; D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001063:Appendiceal Neoplasms / Q000473:pathology / Q000601:surgery*; D001064:Appendicitis / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome