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Medline ® Abstracts for References 8,12-14

of 'Cancer of the appendix and pseudomyxoma peritonei'

8
TI
Carcinoid tumors of the vermiform appendix.
AU
Moertel CG, Dockerty MB, Judd ES
SO
Cancer. 1968;21(2):270.
 
AD
PMID
12
TI
Carcinoid tumor of the appendix: treatment and prognosis.
AU
Moertel CG, Weiland LH, Nagorney DM, Dockerty MB
SO
N Engl J Med. 1987;317(27):1699.
 
In a long-term study of 150 unselected patients with carcinoid tumors of the appendix, we found that the neoplasms were usually less than 1.0 cm in largest dimension and discovered as an incidental finding during surgery performed for other reasons. Metastases were observed with none of the 127 appendiceal carcinoids less than 2.0 cm in largest dimension, with 3 of the 14 lesions greater than or equal to 2.0 cm but less than 3.0 cm in greatest dimension, and with 4 of the 9 lesions greater than or equal to 3.0 cm. Paradoxically, the patients with the larger tumors and metastases were younger than those with smaller and clinically benign tumors. The median age of patients with tumors greater than or equal to 2.0 cm was 31 years and that of those with metastases was 29 years, as compared with a median age of 42 years in patients with nonmetastasizing tumors less than 2.0 cm. We conclude that simple appendectomy is adequate treatment for patients with apparently localized tumors less than 2.0 cm in largest dimension. We have not observed any recurrences or metastases among 122 such patients followed for a median time of more than 26 years. Simple appendectomy is probably also appropriate treatment for lesions greater than or equal to 2.0 cm in elderly patients or in those at high operative risk. Right hemicolectomy seems justified only in young patients with tumors greater than or equal to 2.0 cm who have a low risk of operative morbidity or mortality. Vascular involvement and invasion of the mesoappendix are features that may favor a more radical approach.
AD
Department of Oncology, Mayo Clinic, Rochester, MN 55905.
PMID
13
TI
Carcinoid tumours of the appendix.
AU
Anderson JR, Wilson BG
SO
Br J Surg. 1985;72(7):545.
 
Appendicular carcinoid tumours in 147 patients are presented. Two patients had evidence of metastatic spread at the time of presentation. Both patients had primary tumours less than 2 cm in diameter. Size remains the most reliable guide to the malignant potential of these tumours. If, after simple appendicectomy, a carcinoid tumour is found with a post-formalin fixation diameter greater than 1.5 cm then a subsequent right hemicolectomy should be considered.
AD
PMID
14
TI
Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract.
AU
Rorstad O
SO
J Surg Oncol. 2005;89(3):151.
 
Factors that determine the clinical course and outcome of patients with gastrointestinal (GI) carcinoid tumors are complex and multifaceted. These include the site of origin within the GI tract, the size of the primary tumor, and the anatomical extent of disease, whether localized, regional, or metastatic to distant sites. The new World Health Organization (WHO) histological classification of endocrine tumors, including carcinoids, represents a significant advance in terms of providing a consistent framework for histopathological interpretation that should facilitate multicenter research on treatment outcomes. Histochemical indicators of a poorer prognosis are the degree of expression of the proliferation protein Ki-67 and the p53 tumor suppressor protein. Adverse clinical indicators are the malignant carcinoid syndrome, carcinoid heart disease, and high concentrations of the tumor markers, urinary 5-HIAA and plasma chromogranin A.
AD
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. rorstad@ucalgary.ca
PMID