Appendix cancer natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
The symptoms of (disease name) typically develop ___ years after exposure to ___.
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

Common complications of appendix cancer include:
- Acute appendicitis
- Pseudomyxoma pritonei
- ?????????

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [--]%.
Depending on the extent of the [tumor/disease progression] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
[Subtype of disease/malignancy] is associated with the most favorable prognosis.
The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.


Five year survival rates
Carcinoid tumors
localized disease 94% Regional disease 85% Distant metastases 34% Goblet cell 12.5% Tubular tumors are benign clinically
Adenocarcinoma
Nonmucinus Localized 95% Distant metastasis 0% Mucinous adenocarcinoma localized 80% Distant metastasis 51%

Poor prognostic factors for appendiceal adenocarcinoma are as follows:
- Advanced stage
- High grade
- Nonmucinous histology
- Spread of the tumor beyond the left lower quadrant
- Presence of malignant cells outside of the visceral peritoneum of the appendix
Poor prognostic factors in the presence of pseudomyxoma peritonei are as follows:
- abdominal distension
- weight loss
- high histological grade
- and morphological evidence of invasion of underlying structures