Alabraba, Edward, Pritchard, David Mark ORCID: 0000-0001-7971-3561, Griffin, Rebecca ORCID: 0000-0003-4521-948X, Diaz-Nieto, Rafael, Banks, Melissa, Cuthbertson, Daniel James ORCID: 0000-0002-6128-0822 and Fenwick, Stephen
(2021)
Appendiceal goblet cell carcinomas have poor survival despite completion surgery.
ENDOCRINE, 73 (3).
pp. 734-744.
Text
Endocrine GCC author accepted version.pdf - Author Accepted Manuscript Download (430kB) | Preview |
Abstract
<h4>Purpose</h4>Appendiceal goblet cell carcinomas (aGCCs) are rare but aggressive tumours associated with significant mortality. We retrospectively reviewed the outcomes of aGCC patients treated at our tertiary referral centre.<h4>Methods</h4>We analysed aGCC patients, diagnosed between 1990-2016, assessing the impact of completion surgery and tumour factors on survival. Survival was assessed using Kaplan-Meier analysis.<h4>Results</h4>We identified 41 patients (23 F, 18 M); median age 61 (range 27-79) years. Mean tumour size was 10.5 (range 0.5-50) mm; most tumours were located in the appendiceal tip (n = 18, 45%). Appendicectomy was the index surgery in 32 patients, 24 of whom subsequently underwent completion surgery at median 3 (range 1.3-13.3) months later. Histology from completion surgery showed residual disease in 8 patients: nodal disease (n = 2) or residual tumour (n = 6). Index surgery for the rest was either colectomy (n = 7) or cytoreductive surgery plus intraperitoneal chemotherapy (CRS-HIPEC) (n = 1). Index and completion surgery had 0% mortality and 2.5% morbidity. Overall and recurrence-free survival were not significantly affected by tumour grade or completion surgery. Disease recurred in 9 patients after a median follow-up of 57.0 (4.6-114.9) months; 7 of these patients died during follow-up. Recurrences were treated with CRS-HIPEC (n = 1), palliative chemotherapy (n = 3) or supportive care (n = 5). Five- and ten- year overall survival were 85.3% and 62.3% respectively; 5-year and 10-year recurrence-free survival were 73.6% and 50.6%.<h4>Conclusion</h4>The prognosis of aGCCs remains relatively poor. Completion surgery did not prevent recurrence or improve survival, but this needs to be verified with a larger patient cohort. The high mortality associated with tumour recurrence questions current treatment recommendations.
Item Type: | Article |
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Uncontrolled Keywords: | Appendiceal, Appendix, Completion right hemicolectomy, Completion surgery, Goblet cell carcinoids, Goblet cell carcinomas |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
Depositing User: | Symplectic Admin |
Date Deposited: | 29 Apr 2021 08:36 |
Last Modified: | 08 Mar 2023 09:56 |
DOI: | 10.1007/s12020-021-02727-9 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3120980 |