Primary appendiceal cancer

Gynecologic manifestations and treatment options

C. S. Dietrich, C. P. DeSimone, S. C. Modesitt, P. D. DePriest, F. R. Ueland, E. J. Pavlik, R. Kryscio, M. Cibull, W. Huh, E. Partridge, T. M. Numnum, Jeanne Schilder, R. V. Higgins, J. R. van Nagell

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To determine the presenting symptoms, gynecologic manifestations, and optimal intraoperative management of women with primary appendiceal cancer. Methods: A multi-institutional investigation was performed to identify female patients with primary appendiceal cancer who were treated from 1990 to present. Results: Forty-eight women with primary appendiceal cancer were identified from the tumor registries of participating institutions. The most common symptoms were abdominal pain (40%) and bloating (23%), but only 8% experienced rectal bleeding. Serum CEA was elevated (> 2.5 U/ml) in 67% of patients, and serum Ca-125 was elevated (> 35 U/ml) in 50% of patients. Thirty-one patients (65%) presented with a right adnexal or right lower quadrant mass and were operated on initially by a gynecologic oncologist. Ovarian involvement by metastatic appendiceal cancer was documented in 18 patients (38%). All of these patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and staging, but only 8 had a right hemicolectomy at the time of initial surgery. Forty-one patients (85%) presented with advanced stage appendiceal cancer (Stage III or IV) and 19 patients (46%) received postoperative chemotherapy, most commonly with a combination of 5-FU/Leukovorin. Following surgery, 22 patients (46%) experienced disease progression or recurrence, and 14 have died of disease. The most common sites of recurrence were abdominal or pelvic peritoneum (18), colon (2), and ovary (2). Patient survival was 70% at 2 years, and 60% at 5 years. Conclusion: Women with primary appendiceal cancer frequently present with ovarian metastases, and initial surgical intervention is often performed by a gynecologic oncologist. All patients with mucinous epithelial ovarian cancer should undergo appendectomy at the time of surgical staging. The appendix should be examined intraoperatively, and if appendiceal carcinoma is identified, a right hemicolectomy and appropriate surgical staging should be considered.

Original languageEnglish
Pages (from-to)602-606
Number of pages5
JournalGynecologic Oncology
Volume104
Issue number3
DOIs
StatePublished - Mar 2007

Fingerprint

Appendiceal Neoplasms
Therapeutics
Recurrence
Appendectomy
Leucovorin
Peritoneum
Appendix
Ovariectomy
Serum
Hysterectomy
Fluorouracil
Abdominal Pain

Keywords

  • Myxoma peritonei
  • Optimal treatment
  • Ovarian involvement
  • Primary appendiceal cancer
  • Survival

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Dietrich, C. S., DeSimone, C. P., Modesitt, S. C., DePriest, P. D., Ueland, F. R., Pavlik, E. J., ... van Nagell, J. R. (2007). Primary appendiceal cancer: Gynecologic manifestations and treatment options. Gynecologic Oncology, 104(3), 602-606. https://doi.org/10.1016/j.ygyno.2006.09.014

Primary appendiceal cancer : Gynecologic manifestations and treatment options. / Dietrich, C. S.; DeSimone, C. P.; Modesitt, S. C.; DePriest, P. D.; Ueland, F. R.; Pavlik, E. J.; Kryscio, R.; Cibull, M.; Huh, W.; Partridge, E.; Numnum, T. M.; Schilder, Jeanne; Higgins, R. V.; van Nagell, J. R.

In: Gynecologic Oncology, Vol. 104, No. 3, 03.2007, p. 602-606.

Research output: Contribution to journalArticle

Dietrich, CS, DeSimone, CP, Modesitt, SC, DePriest, PD, Ueland, FR, Pavlik, EJ, Kryscio, R, Cibull, M, Huh, W, Partridge, E, Numnum, TM, Schilder, J, Higgins, RV & van Nagell, JR 2007, 'Primary appendiceal cancer: Gynecologic manifestations and treatment options', Gynecologic Oncology, vol. 104, no. 3, pp. 602-606. https://doi.org/10.1016/j.ygyno.2006.09.014
Dietrich CS, DeSimone CP, Modesitt SC, DePriest PD, Ueland FR, Pavlik EJ et al. Primary appendiceal cancer: Gynecologic manifestations and treatment options. Gynecologic Oncology. 2007 Mar;104(3):602-606. https://doi.org/10.1016/j.ygyno.2006.09.014
Dietrich, C. S. ; DeSimone, C. P. ; Modesitt, S. C. ; DePriest, P. D. ; Ueland, F. R. ; Pavlik, E. J. ; Kryscio, R. ; Cibull, M. ; Huh, W. ; Partridge, E. ; Numnum, T. M. ; Schilder, Jeanne ; Higgins, R. V. ; van Nagell, J. R. / Primary appendiceal cancer : Gynecologic manifestations and treatment options. In: Gynecologic Oncology. 2007 ; Vol. 104, No. 3. pp. 602-606.
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