Clinical Presentation and Prognostic Factors of Primary Appendix Malignancies: A Retrospective Evaluation
Öz
Objective: Appendix cancer (AC) is very rare. Most patients are diagnosed after surgery for acute appendicitis or because of an abdominal mass detected incidentally during computed tomography. This study aims to investigate the tumor histological features and treatment modalities applied to the patients according to the clinical presentation of primary appendix malignant tumors.
Methods: The data of 29 patients who applied to Ankara Yildirim Beyazit University and Ankara Numune Training and Research Hospital between February 2012 and November 2021 and were diagnosed with primary AC were retrospectively analyzed.. The patients were divided into two groups according to the clinical presentation at admission: patients diagnosed with acute appendicitis and patients diagnosed with non-appendicitis clinical complaints.
Results: A total of 29 patients were included in our study. The median age of all patients was 58 (25-76, min-max) years. 19 (65.5%) of the patients consisted of female patients. There were 11 (37.9%) patients who presented with the clinic of acute appendicitis and 18 (62.1%) patients who presented with the clinic of non-appendicitis. Two patients (18.2%) in the group presenting with acute appendicitis clinic and 11 (61.1%) patients in the group presenting with non-appendicitis clinic were diagnosed as stage IV.
Conclusion: In our study, we found that appendix cancers diagnosed after acute appendicitis was diagnosed at earlier stages and had lower rates of pseudomyxoma peritonei (PMP). There were no ex-patients in the group diagnosed with acute appendicitis. This suggests that overall survival will be better in this patient group. Considering that those who are preceded by acute appendicitis are at an earlier stage, the survival differences may be due to this.
Anahtar Kelimeler
Kaynakça
- 1. McCusker, M. E., Coté, T. R., Clegg, L. X., & Sobin, L. H. (2002). Primary malignant neoplasms of the appendix: A population‐based study from the surveillance, epidemiology and end‐results program, 1973–1998. Cancer, 94(12), 3307-3312.
- 2. Turaga, K. K., Pappas, S. G., & Gamblin, T. C. (2012). Importance of histologic subtype in the staging of appendiceal tumors. Annals of Surgical Oncology, 19(5), 1379-1385.
- 3. Trivedi, A. N., Levine, E. A., & Mishra, G. (2009). Adenocarcinoma of the appendix is rarely detected by colonoscopy. Journal of Gastrointestinal Surgery, 13(4), 668-675.
- 4. Nitecki, S. S., Wolff, B. G., Schlinkert, R., & Sarr, M. G. (1994). The natural history of surgically treated primary adenocarcinoma of the appendix. Annals of Surgery, 219(1), 51.
- 5. Marudanayagam, R., Williams, G. T., & Rees, B. I. (2006). Review of the pathological results of 2660 appendicectomy specimens. Journal of Gastroenterology, 41(8), 745-749.
- 6. Wright, G. P., Mater, M. E., Carroll, J. T., Choy, J. S., & Chung, M. H. (2015). Is there truly an oncologic indication for interval appendectomy? The American Journal of Surgery, 209(3), 442-446.
- 7. Carpenter, S. G., Chapital, A. B., Merritt, M. V., & Johnson, D. J. (2012). Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review. The American Surgeon, 78(3), 339-343.
- 8. Sadot, E., Keidar, A., Shapiro, R., & Wasserberg, N. (2013). Laparoscopic accuracy in prediction of appendiceal pathology: oncologic and inflammatory aspects. The American Journal of Surgery, 206(5), 805-809.
- 9. Todd, R. D., Sarosi, G. A., Nwariaku, F., & Anthony, T. (2004). Incidence and predictors of appendiceal tumors in elderly males presenting with signs and symptoms of acute appendicitis. The American Journal of Surgery, 188(5), 500-504.
- 10. Votanopoulos, K. I., Russell, G., Randle, R. W., Shen, P., Stewart, J. H., & Levine, E. A. (2015). Peritoneal surface disease (PSD) from appendiceal cancer treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): overview of 481 cases. Annals of Surgical Oncology, 22(4), 1274-1279.
- 11. Levine, E. A., Stewart IV, J. H., Shen, P., Russell, G. B., Loggie, B. L., & Votanopoulos, K. I. (2014). Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. Journal of the American College of Surgeons, 218(4), 573-585.
- 12. Sylla, M., Ossibi, P. E., Tenkorang, S., Dandakoye, I., Majdoub, K., Toughrai, I., et al. (2018). Adenocarcinoma of the Appendix.
- 13. Connor, S., Hanna, G., & Frizelle, F. (1998). Appendiceal tumors. Diseases of the Colon & Rectum, 41(1), 75-80.
- 14. Blair, N. P., Bugis, S. P., Turner, L. J., & MacLeod, M. M. (1993). Review of the pathologic diagnoses of 2,216 appendectomy specimens. The American Journal of Surgery, 165(5), 618-620.
- 15. Ito, H., Osteen, R. T., Bleday, R., Zinner, M. J., Ashley, S. W., & Whang, E. E. (2004). Appendiceal adenocarcinoma: long-term outcomes after surgical therapy. Diseases of the Colon & Rectum, 47(4), 474-480.
- 16. Asare, E. A., Compton, C. C., Hanna, N. N., Kosinski, L. A., Washington, M. K., Kakar, S., et al. (2016). The impact of stage, grade, and mucinous histology on the efficacy of systemic chemotherapy in adenocarcinomas of the appendix: analysis of the National Cancer Data Base. Cancer, 122(2), 213-221.
- 17. Hyngstrom, J. R., Hu, C. Y., Xing, Y., You, Y. N., Feig, B. W., Skibber, J. M., et al. (2012). Clinicopathology and outcomes for mucinous and signet ring colorectal adenocarcinoma: analysis from the National Cancer Data Base. Annals of Surgical Oncology, 19(9), 2814-2821.
- 18. Ronnett, B. M., Zahn, C. M., Kurman, R. J., Kass, M. E., Sugarbaker, P. H., & Shmookler, B. M. (1995). Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to" pseudomyxoma peritonei". The American Journal of Surgical Pathology, 19(12), 1390-1408.
- 19. Misdraji, J., Yantiss, R. K., Graeme-Cook, F. M., Balis, U. J., & Young, R. H. (2003). Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. The American Journal of Surgical Pathology, 27(8), 1089-1103.
- 20. Kelly, K. J. (2015). Management of appendix cancer. Clinics in Colon and Rectal Surgery, 28(04), 247-255.
- 21. Hata, K., Tanaka, N., Nomura, Y., Wada, I., & Nagawa, H. (2002). Early appendiceal adenocarcinoma. A review of the literature with special reference to optimal surgical procedures. Journal of Gastroenterology, 37(3), 210.
- 22. Stewart, J. H., Shen, P., Russell, G. B., Bradley, R. F., Hundley, J. C., Loggie, B. L., et al. (2006). Appendiceal neoplasms with peritoneal dissemination: outcomes after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy. Annals of Surgical Oncology, 13(5), 624-634.
Primer Apendiks Malignitelerinin Klinik Prezantasyonu ve Prognostik Faktörler: Retrospektif bir değerlendirme
Öz
Amaç: Apendiks kanseri (AC), çok nadir görülmektedir. Çoğu hasta akut apandisit nedeniyle opere olduktan sonra veya çekilen bilgisayarlı tomografi sırasında tesadüfen saptanan abdominal kitle nedeniyle tanı almaktadır. Bu çalışmanın amacı, primer apendiks malign tümörlerinin klinik prezantasyonuna göre hastaların tümör histolojik özelliklerini ve hastalara uygulanan tedavi modalitelerini araştırmaktır.
Yöntem: Şubat 2012 ile Kasım 2021 tarihleri arasında XXX Üniversitesi ile XXX Eğitim ve Araştırma Hastanesi’ne başvuran ve primer AC tanısı alan 29 hastanın verileri retrospektif olarak incelendi. Hastalar başvuru klinik prezantasyonlarına göre; akut apandisit ve apandisit-dışı klinik şikayetleri ile tanı alan hastalar şeklinde iki gruba ayrıldı.
Bulgular: Çalışmamıza toplam 29 hasta alındı. Tüm hastaların medyan yaşı 58 (25-76, min-max) yıldı. Hastaların 19’u (%65,5) kadın hastalardan oluşmaktaydı. Akut apandisit kliniği ile başvuran 11 (%37,9) hasta, apandisit-dışı klinik ile başvuran 18 (%62,1) hasta bulunmaktaydı. Akut apandisit kliniği ile prezante olan grupta iki hasta (%18,2) apandisit-dışı klinik ile prezante olan grupta ise 11 (%61,1) hasta evre-IV olarak tanı almıştı.
Sonuç: Çalışmamızda akut apandisit kliniği sonrası tanı konulan apendiks kanserlerinin daha erken evrelerde tanı aldıklarını, daha düşük psödomiksoma peritonei (PMP) oranlarının olduğunu tespit ettik. Akut apandisit kliniği ile tanı konulan grupta hayatını kaybeden hastamız bulunmamaktaydı. Bu da genel sağkalımın bu hasta grubunda daha iyi olacağını düşündürmektedir. Akut apandisit ile prezante olanların daha erken evrede olması göz önüne alınınca sağkalım farklılıkları buradan kaynaklanıyor olabilir.
Anahtar Kelimeler
Kaynakça
- 1. McCusker, M. E., Coté, T. R., Clegg, L. X., & Sobin, L. H. (2002). Primary malignant neoplasms of the appendix: A population‐based study from the surveillance, epidemiology and end‐results program, 1973–1998. Cancer, 94(12), 3307-3312.
- 2. Turaga, K. K., Pappas, S. G., & Gamblin, T. C. (2012). Importance of histologic subtype in the staging of appendiceal tumors. Annals of Surgical Oncology, 19(5), 1379-1385.
- 3. Trivedi, A. N., Levine, E. A., & Mishra, G. (2009). Adenocarcinoma of the appendix is rarely detected by colonoscopy. Journal of Gastrointestinal Surgery, 13(4), 668-675.
- 4. Nitecki, S. S., Wolff, B. G., Schlinkert, R., & Sarr, M. G. (1994). The natural history of surgically treated primary adenocarcinoma of the appendix. Annals of Surgery, 219(1), 51.
- 5. Marudanayagam, R., Williams, G. T., & Rees, B. I. (2006). Review of the pathological results of 2660 appendicectomy specimens. Journal of Gastroenterology, 41(8), 745-749.
- 6. Wright, G. P., Mater, M. E., Carroll, J. T., Choy, J. S., & Chung, M. H. (2015). Is there truly an oncologic indication for interval appendectomy? The American Journal of Surgery, 209(3), 442-446.
- 7. Carpenter, S. G., Chapital, A. B., Merritt, M. V., & Johnson, D. J. (2012). Increased risk of neoplasm in appendicitis treated with interval appendectomy: single-institution experience and literature review. The American Surgeon, 78(3), 339-343.
- 8. Sadot, E., Keidar, A., Shapiro, R., & Wasserberg, N. (2013). Laparoscopic accuracy in prediction of appendiceal pathology: oncologic and inflammatory aspects. The American Journal of Surgery, 206(5), 805-809.
- 9. Todd, R. D., Sarosi, G. A., Nwariaku, F., & Anthony, T. (2004). Incidence and predictors of appendiceal tumors in elderly males presenting with signs and symptoms of acute appendicitis. The American Journal of Surgery, 188(5), 500-504.
- 10. Votanopoulos, K. I., Russell, G., Randle, R. W., Shen, P., Stewart, J. H., & Levine, E. A. (2015). Peritoneal surface disease (PSD) from appendiceal cancer treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): overview of 481 cases. Annals of Surgical Oncology, 22(4), 1274-1279.
- 11. Levine, E. A., Stewart IV, J. H., Shen, P., Russell, G. B., Loggie, B. L., & Votanopoulos, K. I. (2014). Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. Journal of the American College of Surgeons, 218(4), 573-585.
- 12. Sylla, M., Ossibi, P. E., Tenkorang, S., Dandakoye, I., Majdoub, K., Toughrai, I., et al. (2018). Adenocarcinoma of the Appendix.
- 13. Connor, S., Hanna, G., & Frizelle, F. (1998). Appendiceal tumors. Diseases of the Colon & Rectum, 41(1), 75-80.
- 14. Blair, N. P., Bugis, S. P., Turner, L. J., & MacLeod, M. M. (1993). Review of the pathologic diagnoses of 2,216 appendectomy specimens. The American Journal of Surgery, 165(5), 618-620.
- 15. Ito, H., Osteen, R. T., Bleday, R., Zinner, M. J., Ashley, S. W., & Whang, E. E. (2004). Appendiceal adenocarcinoma: long-term outcomes after surgical therapy. Diseases of the Colon & Rectum, 47(4), 474-480.
- 16. Asare, E. A., Compton, C. C., Hanna, N. N., Kosinski, L. A., Washington, M. K., Kakar, S., et al. (2016). The impact of stage, grade, and mucinous histology on the efficacy of systemic chemotherapy in adenocarcinomas of the appendix: analysis of the National Cancer Data Base. Cancer, 122(2), 213-221.
- 17. Hyngstrom, J. R., Hu, C. Y., Xing, Y., You, Y. N., Feig, B. W., Skibber, J. M., et al. (2012). Clinicopathology and outcomes for mucinous and signet ring colorectal adenocarcinoma: analysis from the National Cancer Data Base. Annals of Surgical Oncology, 19(9), 2814-2821.
- 18. Ronnett, B. M., Zahn, C. M., Kurman, R. J., Kass, M. E., Sugarbaker, P. H., & Shmookler, B. M. (1995). Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to" pseudomyxoma peritonei". The American Journal of Surgical Pathology, 19(12), 1390-1408.
- 19. Misdraji, J., Yantiss, R. K., Graeme-Cook, F. M., Balis, U. J., & Young, R. H. (2003). Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. The American Journal of Surgical Pathology, 27(8), 1089-1103.
- 20. Kelly, K. J. (2015). Management of appendix cancer. Clinics in Colon and Rectal Surgery, 28(04), 247-255.
- 21. Hata, K., Tanaka, N., Nomura, Y., Wada, I., & Nagawa, H. (2002). Early appendiceal adenocarcinoma. A review of the literature with special reference to optimal surgical procedures. Journal of Gastroenterology, 37(3), 210.
- 22. Stewart, J. H., Shen, P., Russell, G. B., Bradley, R. F., Hundley, J. C., Loggie, B. L., et al. (2006). Appendiceal neoplasms with peritoneal dissemination: outcomes after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy. Annals of Surgical Oncology, 13(5), 624-634.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mayıs 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 7 Sayı: 2 |
Kaynak Göster
Cited By
Can Appendiceal Neoplasms Be Predicted in Patients with Presumed Acute Appendicitis?
European Journal of Therapeutics
https://doi.org/10.58600/eurjther1977
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