Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Ann Surg Oncol. 2019 Jan;26(1):118-124. doi: 10.1245/s10434-018-7003-7. Epub 2018 Nov 12.
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.
背景:偶有低度阑尾黏液性肿瘤(LAMN)表现为局限于阑尾周围组织或弥漫于整个腹膜的黏液性腹膜沉积物(MPD)。 目的:本研究旨在评估黏液细胞丰富度对于预测伴有远处 MPD 的 LAMN 结局的相关性。 方法:回顾性分析了 1990 年至 2015 年在综合癌症中心接受初始评估的伴有 LAMN 和远处 MPD 的患者的记录,分析了诊断程序、治疗和结局。 结果:在纳入分析的 48 例患者中,19 例有细胞性 MPD(CMPD),29 例为非细胞性 MPD。在接受细胞减灭术的 33 例患者中,30 例获得完全细胞减灭术;3 例不完全细胞减灭术的患者均为 CMPD。在随访期间(中位数为 4 年),6 例患者死于该疾病,均为 CMPD。在 11 例疾病进展的患者中,10 例为 CMPD。 结论:远处 MPD 的细胞丰富度是 LAMN 疾病结局的重要决定因素。对于伴有 LAMN 和 AMPD 的特定患者,主动监测等方法可能具有一定作用。
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