González Bayón Luis, Martín Román Lorena, Lominchar Pablo Lozano
Peritoneal Carcinomatosis Unit, Department of General Surgery, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Cancers (Basel). 2023 Jun 30;15(13):3426. doi: 10.3390/cancers15133426.
Appendiceal mucinous neoplasms have been classified differently over time causing confusion when comparing results between working groups in this field and establishing a prognosis of the disease. A historical perspective of the different classification systems of these tumors is essential for the understanding of the evolution of concepts and histopathological definitions that have led up to the present moment. We carried out a systematic review of the pathological classifications of appendiceal mucinous tumors and how they have included the new criteria resulting from clinical and pathological research. The latest classifications by PSOGI and AJCC 8th edition Cancer Staging have made a great effort to incorporate the new pathological descriptions and develop prognostic groups. The introduction of these new classification systems has posed the challenge of verifying how they adapt to our casuistry and which one defines best the prognosis of our patients. We reclassified our series of patients treated for mucinous appendiceal tumors with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy following the PSOGI and the AJCC 8th edition criteria and concluded that both classifications correspond well with the OS and DFS of these patients, with some advantage relative to the PSOGI classification due to a better histopathological description of the different groups.
随着时间的推移,阑尾黏液性肿瘤的分类有所不同,这使得在比较该领域不同研究团队的结果以及确定该疾病的预后时产生了混乱。了解这些肿瘤不同分类系统的历史背景对于理解概念的演变以及导致当前组织病理学定义的过程至关重要。我们对阑尾黏液性肿瘤的病理分类以及它们如何纳入临床和病理研究产生的新标准进行了系统综述。PSOGI和美国癌症联合委员会(AJCC)第8版癌症分期的最新分类做出了巨大努力,纳入了新的病理描述并制定了预后分组。这些新分类系统的引入带来了一个挑战,即验证它们如何适用于我们的病例情况,以及哪一种最能确定我们患者的预后。我们按照PSOGI和AJCC第8版标准对接受减瘤手术和腹腔热灌注化疗的阑尾黏液性肿瘤患者系列进行了重新分类,得出结论:两种分类与这些患者的总生存期(OS)和无病生存期(DFS)都有很好的对应关系,相对于PSOGI分类有一些优势,因为它对不同组别的组织病理学描述更好。