title: Goblet cell carcinoid tumor, mixed goblet cell carcinoid-adenocarcinoma, and adenocarcinoma of the appendix: comparison of clinicopathologic features and prognosis.
abstract: BACKGROUND
  The prognosis of appendiceal goblet cell carcinoid tumors (GCTs) is believed to be intermediate between appendiceal adenocarcinomas and conventional carcinoid tumors. However, GCTs can have mixed morphologic patterns, with variable amount of adenocarcinoma.
  
  
  OBJECTIVE
  To evaluate the behavior of GCTs and related entities with variable components of adenocarcinoma.
  
  
  METHODS
  We classified 74 cases of appendiceal tumors into 3 groups: group 1, GCTs or GCTs with less than 25% adenocarcinoma; group 2, GCTs with 25% to 50% adenocarcinoma; group 3, GCTs with more than 50% adenocarcinoma; and a comparison group of 68 adenocarcinomas without a GCT component (group 4). Well-differentiated mucinous adenocarcinomas were excluded. Clinicopathologic features and follow-up were obtained from computerized medical records and the US Social Security Death Index.
  
  
  RESULTS
  Of the 142 tumors studied, 23 tumors (16%) were classified as group 1; 27 (19%) as group 2; 24 (17%) as group 3; and 68 (48%) as group 4. Staging and survival differed significantly among these groups. Among 140 patients (99%) with available staging data, stages II, III, and IV were present in 87%, 4%, and 4% of patients in group 1 patients; 67%, 7%, and 22% of patients in group 2; 29%, 4%, and 67% of patients in group 3; and 19%, 6%, and 75% of patients in group 4, respectively (P = .01). Mean (SD) overall survival was 83.8 (34.6), 60.6 (30.3), 45.6 (39.7), and 33.6 (27.6) months for groups 1, 2, 3, and 4, respectively (P = .01). By multivariate analysis, only stage and tumor category were independent predictors of overall survival.
  
  
  CONCLUSIONS
  Our data highlight the importance of subclassifying the proportion of adenocarcinoma in appendiceal tumors with GCT morphology because that finding reflects disease stage and affects survival.
authors.affiliation: From the Departments of Pathology (Drs Taggart, Abraham, and Rashid), Medical Oncology (Dr Overman), and Surgical Oncology (Dr Mansfield), MD Anderson Cancer Center, University of Texas, Houston.
authors.forename: Melissa W
authors.initials: MW
authors.lastname: Taggart
authors.forename: Susan C
authors.initials: SC
authors.lastname: Abraham
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Overman
authors.forename: Paul F
authors.initials: PF
authors.lastname: Mansfield
authors.forename: Asif
authors.initials: A
authors.lastname: Rashid
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001065:Appendix / Q000473:pathology*; D002276:Carcinoid Tumor / Q000473:pathology*; D005260:Female; D020397:Goblet Cells / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D055815:Young Adult
chemical_list: D009077:Mucins