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
- The majority of patients with appendix cancer may be initially asymptomatic.
- Most of appendix cancer cases are discovered after surgical or histological evaluation of a patient with cute appendicitis, or are an accidental finding in a radiologic imaging study for other reasons.
- Early clinical features include periodical unspecific abdominal pain, bloating, and nausea.
- If left untreated, the majority of patients with appendix cancer may progress to develop peritoneal carcinomatosis and metastases.
- Prognosis is generally excellent and good in carcinoid tumors and adenocarcinoma respectively.
- Tumor size plays a crucial role in determining prognosis.
- Most of appendiceal tumors are less than 2 cm in size and have a quite favorable prognosis since they barely metastasize.[1][2]A poorer survival has been reported for the black patients with carcinoid tumors. [2]
- The overall 5-year survival rate for adenocarcinoma of appendix is approximately 71% (see the Table below). Closing
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- Presence of mutated TP53 and APC genes were significantly lower in appendiceal cancers compared to colorectal cancers.
- It has been shown that mutation profiles are associated with the patients’ prognosis. [3]
- Mutations in the TP53 significantly decrease life expectancy in patients with appendix cancer.
- Regardless of tumor grade, Tp 53 mutations were associated with poorer outcomes.
- Patients with GNAS mutations had a life expectancy of 10 years after diagnosis.
- Appendiceal tumors with GNAS mutations rarely develop into high-grade tumors.
References
- ↑ Irvin M. Modlin, Kevin D. Lye & Mark Kidd (2003). "A 5-decade analysis of 13,715 carcinoid tumors". Cancer. 97 (4): 934–959. doi:10.1002/cncr.11105. PMID 12569593. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Melinda A. Maggard, Jessica B. O'Connell & Clifford Y. Ko (2004). "Updated population-based review of carcinoid tumors". Annals of surgery. 240 (1): 117–122. PMID 15213627. Unknown parameter
|month=ignored (help) - ↑ Levine EA, Votanopoulos KI, Qasem SA, Philip J, Cummins KA, Chou JW; et al. (2016). "Prognostic Molecular Subtypes of Low-Grade Cancer of the Appendix". J Am Coll Surg. 222 (4): 493–503. doi:10.1016/j.jamcollsurg.2015.12.012. PMC 4808611. PMID 26821970.