Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in 92 Patients with Peritoneal Metastases from Appendiceal Goblet Cell Adenocarcinoma.

Vladimir Milovanov, Brendan Moran, Faheez Mohamed, Shoura Karar, Alexios Tzivanakis, Sanjeev Dayal, Tom Cecil

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Vladimir MilovanovClinical Fellow in Peritoneal Surface Malignancy, Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire, UK. vladimirmilovanov@gmail.com.

Brendan MoranConsultant Colorectal and Peritoneal Malignancy Surgeon, Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Faheez MohamedConsultant Colorectal and Peritoneal Malignancy Surgeon, Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Shoura KararRegistrar Colorectal and General Surgery, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Alexios TzivanakisConsultant Colorectal and Peritoneal Malignancy Surgeon, Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Sanjeev DayalConsultant Colorectal and Peritoneal Malignancy Surgeon, Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Tom CecilConsultant Colorectal and General Surgeon, Clinical Director of the Peritoneal Malignancy Institute, Basingstoke and North Hampshire Hospital, Basingstoke, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGoblet cell adenocarcinoma (GCA) of the appendix with peritoneal metastases poses treatment challenges. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers a potentially curative approach. This study evaluates outcomes in patients with appendiceal GCA undergoing CRS/HIPEC.

methodsWe retrospectively analyzed 92 patients with GCA and peritoneal metastases treated by CRS/HIPEC. Tumour markers were assessed preoperatively. All underwent midline laparotomy and peritoneal cancer index (PCI) calculation. Mitomycin C (10 mg/m

resultsMean age was 58 years; 35% male. Tumours were classified by Tang criteria: Tang A (2), Tang B (39), Tang C (40), and 11 unclassified. Mean operative time was 7 hours; mean PCI was 18. Complete cytoreduction (CC 0-1) was achieved in 67%. No perioperative mortality occurred. Postoperative complications occurred in 64%, with 6% grade 3/4. Median follow-up was 88 months. PCI < 20 had median overall survival (OS) of 34 months versus 11 months for PCI > 20 (p < 0.0001). Median OS was 30 months in CC 0-1 versus 11 months in CC 2-3 (p = 0.0004). Median progression-free survival in CC 0-1 was 13 months. Positive lymph nodes were found in 67%, with no significant OS difference. Elevated CA125 (> 3× normal) predicted poorer prognosis (median OS 9 vs. 29 months; p = 0.0116). Overall median OS was 23 months; 5-year survival was 14%.

conclusionCRS and HIPEC provide 14% 5-year survival for GCA with peritoneal metastases. Complete cytoreduction, especially with PCI < 20, improves outcomes.

Indexed as

AdenocarcinomaAppendiceal NeoplasmsCytoreduction Surgical ProceduresHyperthermia, InducedHyperthermic Intraperitoneal ChemotherapyPeritoneal NeoplasmsAdultAgedCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedMitomycinPrognosisMitomycin

Identifiers

PMID41402691

DOI10.1016/j.suronc.2015.01.001

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