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Medline ® Abstract for Reference 58

of 'Cancer of the appendix and pseudomyxoma peritonei'

58
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Varying malignant potential of appendiceal neuroendocrine tumors: importance of histologic subtype.
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Hsu C, Rashid A, Xing Y, Chiang YJ, Chagpar RB, Fournier KF, Chang GJ, You YN, Feig BW, Cormier JN
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J Surg Oncol. 2013;107(2):136.
 
BACKGROUND: Neuroendocrine tumors (NETs) of the appendix include malignant carcinoid tumor (MCT), goblet cell carcinoid (GCT), and composite goblet cell carcinoid-adenocarcinoma (CGCC-A).
METHODS: We compared characteristics and outcomes of these histologic subtypes. Patients with appendiceal NETs were identified from the National Cancer Database (1998-2007). Descriptive statistics were used to compare cohorts and associations between clinicopathologic factors and overall survival (OS) were examined using Cox proportional hazards models.
RESULTS: A total of 2,812 patients with appendiceal NETs were identified. The most common histologic subtype was GCT (59.6%), followed by MCT (32.1%), CGCC-A (6.9%), and others (1.4%). CGCC-A had a significantly higher incidence of lymph node metastases (odds ratio [OR], 3.2; 95% confidence interval [CI], 2.1-4.8) and distant metastases (OR, 6.0; 95% CI = 3.8-9.3) than GCT. The 5-year OS was 86.3% (95% CI, 81.4-89.9) for MCT, 77.6% (95% CI, 74.0-80.8) for GCT, and 56.3% (95% CI, 42.1-68.4) for CGCC-A (P<0.0001).
CONCLUSION: Appendiceal NETs represent a spectrum of disease with varying malignant potential: MCT (low), GCT (intermediate), and CGCC-A (high). GCTs represent the most common subtype, whereas CGCC-As place the patient at highest risk for regional and distant metastases and have the worst prognosis.
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Department of Surgical Oncology and Cancer Surgical Outcomes Group, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030-1402, USA.
PMID