Outcomes of Low-Grade Appendiceal Mucinous Neoplasms with Remote Acellular Mucinous Peritoneal Deposits

Background Occasionally, low-grade appendiceal mucinous neoplasms (LAMN) present with mucinous peritoneal deposits (MPD) localized to periappendiceal tissue or diffused throughout the peritoneum. Objective This study was aimed at evaluating the relevance of mucin cellularity for predicting outcomes...

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Bibliographic Details
Published in:Annals of surgical oncology 2019-01, Vol.26 (1), p.118-124
Main Authors: Roxburgh, Campbell S., Fenig, Yaniv M., Cercek, Andrea, Shia, Jinru, Rassam, Rachel M., Paty, Philip B., Nash, Garrett M.
Format: Article
Language:English
Subjects:
Adenocarcinoma, Mucinous - mortality
Adenocarcinoma, Mucinous - pathology
Adenocarcinoma, Mucinous - surgery
Aged
Appendiceal Neoplasms - mortality
Appendiceal Neoplasms - pathology
Appendiceal Neoplasms - surgery
Cancer
Cytoreduction Surgical Procedures - mortality
Female
Follow-Up Studies
Gastrointestinal Oncology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Mucin
Neoplasia
Neoplasm Grading
Oncology
Peritoneal Neoplasms - mortality
Peritoneal Neoplasms - pathology
Peritoneal Neoplasms - surgery
Peritoneum
Surgery
Surgical Oncology
Survival Rate
Tumors
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Summary:Background Occasionally, low-grade appendiceal mucinous neoplasms (LAMN) present with mucinous peritoneal deposits (MPD) localized to periappendiceal tissue or diffused throughout the peritoneum. Objective This study was aimed at evaluating the relevance of mucin cellularity for predicting outcomes of LAMN with remote MPD. Methods The records of patients with LAMN and remote MPD who underwent initial assessment at a comprehensive cancer center from 1990 to 2015 were reviewed, and diagnostic procedures, treatments, and outcomes were analyzed. Results Of 48 patients included in the analysis, 19 had cellular MPD (CMPD) and 29 had acellular MPD. Of 33 patients who underwent cytoreductive surgery, 30 had a complete cytoreduction; the 3 patients with an incomplete cytoreduction had CMPD. In the follow-up period (median, 4 years), 6 patients died of the disease, all of whom had CMPD. Of 11 patients who had progression of disease, 10 had CMPD. Conclusion Cellularity of remote MPD is an important determinant of disease outcome in LAMN. Approaches such as active surveillance may have a role in selected patients with LAMN and AMPD.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-018-7003-7