Effectiveness of treatment modalities for signet ring cell adenocarcinoma of the appendix

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-09 DOI:10.1016/j.amjsurg.2025.116549

Hoe Yan Hor , Melody Pi Yin Tu , Arshia Pessaran , Po Hong Tan , Richard Max Miller , Emily R. Thompson , Travis E. Grotz , Emmanuel M. Gabriel , Sanjay P. Bagaria , Zhi Ven Fong , Nabil Wasif

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Abstract

Background

Signet Ring Cell Adenocarcinoma (SRCA) of the appendix is a rare tumor with a poor prognosis and limited information to help guide treatment.

Methods

We reviewed patients diagnosed with SRCA between 1998 and 2024 at all Mayo Clinic sites.

Results

Among 84 patients, the most common presentation was non-specific abdominal pain (31 %). The majority of tumors were high grade (81 %), and most patients had metastatic disease (69 %). The best overall survival at 5 years was 25 % with complete cytoreduction, which was not significantly improved with the addition of systemic therapy. The addition of HIPEC to cytoreduction surgery showed a clinically significant but not a statistically significant improvement in 5-year survival (20 % vs 5 %, p = 0.059).

Conclusions

Cytoreductive surgery with HIPEC showed the best survival outcomes for SRCA, with no demonstrated efficacy for systemic chemotherapy. Overall outcomes remain poor and new treatment modalities are needed.

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阑尾印戒细胞腺癌治疗方式的有效性

阑尾丝状环细胞腺癌（SRCA）是一种罕见的肿瘤，预后差，指导治疗的信息有限。方法我们回顾了1998年至2024年间梅奥诊所所有诊断为SRCA的患者。结果84例患者中，最常见的表现是非特异性腹痛（31%）。大多数肿瘤为高级别（81%），大多数患者有转移性疾病（69%）。在完全细胞减少的情况下，5年的最佳总生存率为25%，而全身治疗的增加并没有显著改善。在细胞减少手术中加入HIPEC，在5年生存率上有临床显著的改善，但在统计学上没有显著的改善（20% vs 5%, p = 0.059）。结论HIPEC减胞术对SRCA的生存效果最好，但对全身化疗无明显疗效。总体结果仍然很差，需要新的治疗方式。

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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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.