The Role of Adjuvant Chemotherapy in Non-Metastatic Goblet Cell Carcinoid of the Appendix: An 11-Year Experience from th
- PDF / 403,875 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 61 Downloads / 149 Views
ORIGINAL ARTICLE – PERITONEAL SURFACE MALIGNANCY
The Role of Adjuvant Chemotherapy in Non-Metastatic Goblet Cell Carcinoid of the Appendix: An 11-Year Experience from the National Cancer Database Samer AlMasri, MD1, Ibrahim Nassour, MD, MSCS1, Stacy J. Kowalsky, MD1, Katherine Hrebinko, MD1, Aatur D. Singhi, MD, PhD2, Kenneth K. Lee, MD1, Haroon A. Choudry, MD1, David Bartlett, MD3, Amer Zureikat, MD1, and Alessandro Paniccia, MD1 1
Department of Surgery, Division of Surgical Oncology, University of Pittsburgh, Pittsburgh, PA; 2Department of Pathology, University of Pittsburgh, Pittsburgh, PA; 3Department of Surgery, Allegheny Health Network, Pittsburgh, PA
ABSTRACT Background. Goblet cell carcinoids (GCC) are an aggressive, albeit rare, subtype of appendiceal tumors that exhibit distinct histologic features and lack clear treatment guidelines. We aimed to ascertain the impact of adjuvant chemotherapy (AC) for GCC in a national cohort of patients. Methods. Patients who underwent a right hemicolectomy for stage I–III GCC of the appendix between 2006 and 2016 were selected from the National Cancer Database (NCDB). Stratification based on AC receipt was performed. Kaplan–Meier survival estimates and Cox proportional hazard regression were used to identify predictors of overall survival (OS). Results. A total of 867 patients were identified, of whom 124 (14%) received AC. Patients in the AC group were significantly younger (54 vs. 57 years; p = 0.006) and were predominantly of male sex (60 vs. 48%; p = 0.012). On histopathology, patients in the AC group had a higher proportion of poorly/undifferentiated grade (27 vs. 5%; p \ 0.001), T4 disease (35 vs. 11%; p \ 0.001), and lymph
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09389-3) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 14 August 2020 Accepted: 3 November 2020 A. Paniccia, MD e-mail: [email protected]
node-positive disease (45 vs. 7%; p \ 0.001) than patients who did not receive AC. After excluding patients diagnosed in 2016 due to a lack of follow-up data (n = 162), a survival advantage for the AC group was detected only after stratification for lymph node-positive disease (p = 0.007). On Cox proportional hazard regression, AC demonstrated an independent association with improved OS (hazard ratio 0.24, 95% confidence interval 0.084–0.683; p = 0.007). Conclusion. The current analysis from the NCDB supports the role of AC for GCC of the appendix, chiefly for patients with lymph node metastatic disease.
Goblet cell carcinoid (GCC) is a rare subtype of primary appendiceal neoplasms that exhibits features of both neuroendocrine differentiation and intestinal-type goblet cell morphology.1,2 Its incidence approaches 0.01–0.05 per 100,000 persons annually and accounts for 15% of all appendiceal neoplasms.3,4 GCC was first described by Gagne´ et al.5 in 1969, but it was not until a larger case series authored by Subbuswamy et
Data Loading...
