Neoplastic appendiceal mucinous lesions: a narrative review of the literature from an oncologist’s perspective

Carlos Ayala-de Miguel, Jerónimo Jiménez-Castro, Adrián Sánchez-Vegas, Sebastián Díaz-López, Manuel Chaves-Conde
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Abstract

Appendiceal mucinous lesions’ classification and nomenclature has been modified several times along the last decades, reflecting their great heterogeneity and making difficult to compare results and draw conclusions. Despite its nearby origin, appendiceal mucinous lesions have a distinctive behaviour compared to colorectal cancer, including their molecular and genetic markers. Due to their low frequency, their management is not well standardised. However, surgery is considered the cornerstone of treatment. Their indolent behaviour has encouraged surgeons to apply more aggressive treatments, such as cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC), that may extend overall survival. Chemotherapy is reserved for unresectable and/or disseminated disease and could play a role in the adjuvant and neoadjuvant setting. Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is recently emerging as a possible alternative for treatment in advanced disease although its results in long-term survival are lacking Hereby, we review the available evidence in the management of appendiceal mucinous lesions, including localised and disseminated disease, with a special emphasis on the oncological perspective, focusing on the lights and shadows of the systemic treatments.

肿瘤性阑尾粘液性病变:从肿瘤学家的角度对文献的叙述性回顾
过去几十年来,阑尾粘液性病变的分类和命名经过了多次修改,反映了其巨大的异质性,使得比较结果和得出结论变得困难。尽管阑尾粘液性病变起源于附近地区,但与结肠直肠癌相比,它们有独特的表现,包括其分子和遗传标记。由于发病率较低,其治疗方法还没有很好地标准化。不过,手术被认为是治疗的基石。这种癌症的惰性促使外科医生采用更积极的治疗方法,如细胞还原手术(CRS)和腹腔内加热化疗(HIPEC),从而延长总生存期。化疗适用于无法切除和/或扩散的疾病,可在辅助和新辅助治疗中发挥作用。最近,腹腔内加压气溶胶化疗(PIPAC)正在成为晚期疾病治疗的一种可能的替代疗法,但其在长期生存方面的效果尚不明显。 在此,我们回顾了阑尾粘液性病变(包括局部病变和播散性疾病)治疗方面的现有证据,特别强调了肿瘤学的观点,重点是系统治疗的光与影。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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