Elizabeth L. Godfrey MD, Forest Mahoney BS, Varun V. Bansal MBBS, David G. Su MD, David N. Hanna MD, Felipe Lopez-Ramirez MD, Ekaterina Baron MD, Kiran K. Turaga MD, MPH, Al B. Benson III MD, Namrata Setia MD, Joshua H. Winer MD, Craig G. Gunderson MD, Rupen Shah MD, Deepa R. Magge MD, Ian Solsky MD, MPH, Cathy Eng MD, Oliver S. Eng MD, Ardaman Shergill MD, MSPH, John Paul Shen MD, Joseph Misdraji MD, Michael B. Foote MD, Wenyi Luo MD, Peritoneal Surface Malignancies Consortium Group
{"title":"阑尾肿瘤患者治疗的共识指南，第2部分：阑尾肿瘤累及腹膜","authors":"Elizabeth L. Godfrey MD, Forest Mahoney BS, Varun V. Bansal MBBS, David G. Su MD, David N. Hanna MD, Felipe Lopez-Ramirez MD, Ekaterina Baron MD, Kiran K. Turaga MD, MPH, Al B. Benson III MD, Namrata Setia MD, Joshua H. Winer MD, Craig G. Gunderson MD, Rupen Shah MD, Deepa R. Magge MD, Ian Solsky MD, MPH, Cathy Eng MD, Oliver S. Eng MD, Ardaman Shergill MD, MSPH, John Paul Shen MD, Joseph Misdraji MD, Michael B. Foote MD, Wenyi Luo MD, Peritoneal Surface Malignancies Consortium Group","doi":"10.1002/cncr.35874","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Appendiceal tumors comprise a heterogeneous group of tumors that frequently disseminate to the peritoneum. Management of appendiceal tumors is lacking high-quality data given their rarity and heterogeneity. In general, appendiceal tumor treatment is extrapolated in part from colorectal cancer or pooled studies, without definitive evidence of disease-specific benefit. Many practices are controversial and vary widely between institutions. A national consensus update of best management practices for appendiceal malignancies was performed to better standardize care. Herein, the authors present recommendations for the management of appendiceal tumors with peritoneal involvement.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>As previously described, modified Delphi consensus was performed to update the previous 2018 Chicago Consensus guideline. Recommendations were supported by using rapid systematic reviews of key issues in surgical and systemic therapy. Key pathology concepts and recommendations were synthesized in collaboration with content experts.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A consensus-based pathway was generated for any type of non-neuroendocrine appendiceal tumor with peritoneal involvement. The first round of Delphi consensus included 138 participants, of whom 133 (96%) participated in the second round, and greater than 90% consensus was achieved for all pathway blocks. Key items included recommending evaluation for cytoreduction to most patients with low-grade peritoneal disease who are surgical candidates and to many patients with high-grade disease, as well as timing of systemic chemotherapy and surveillance protocols. Common pitfalls in pathologic classification and their clinical implications are also presented.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>These consensus recommendations provide guidance regarding the management of appendiceal tumors with peritoneal involvement, including a review of current evidence in the management of recurrent and unresectable disease.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 13","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Consensus guideline for the management of patients with appendiceal tumors, part 2: Appendiceal tumors with peritoneal involvement\",\"authors\":\"Elizabeth L. Godfrey MD, Forest Mahoney BS, Varun V. Bansal MBBS, David G. Su MD, David N. Hanna MD, Felipe Lopez-Ramirez MD, Ekaterina Baron MD, Kiran K. Turaga MD, MPH, Al B. Benson III MD, Namrata Setia MD, Joshua H. Winer MD, Craig G. Gunderson MD, Rupen Shah MD, Deepa R. Magge MD, Ian Solsky MD, MPH, Cathy Eng MD, Oliver S. Eng MD, Ardaman Shergill MD, MSPH, John Paul Shen MD, Joseph Misdraji MD, Michael B. Foote MD, Wenyi Luo MD, Peritoneal Surface Malignancies Consortium Group\",\"doi\":\"10.1002/cncr.35874\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Appendiceal tumors comprise a heterogeneous group of tumors that frequently disseminate to the peritoneum. Management of appendiceal tumors is lacking high-quality data given their rarity and heterogeneity. In general, appendiceal tumor treatment is extrapolated in part from colorectal cancer or pooled studies, without definitive evidence of disease-specific benefit. Many practices are controversial and vary widely between institutions. A national consensus update of best management practices for appendiceal malignancies was performed to better standardize care. Herein, the authors present recommendations for the management of appendiceal tumors with peritoneal involvement.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>As previously described, modified Delphi consensus was performed to update the previous 2018 Chicago Consensus guideline. Recommendations were supported by using rapid systematic reviews of key issues in surgical and systemic therapy. Key pathology concepts and recommendations were synthesized in collaboration with content experts.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A consensus-based pathway was generated for any type of non-neuroendocrine appendiceal tumor with peritoneal involvement. The first round of Delphi consensus included 138 participants, of whom 133 (96%) participated in the second round, and greater than 90% consensus was achieved for all pathway blocks. Key items included recommending evaluation for cytoreduction to most patients with low-grade peritoneal disease who are surgical candidates and to many patients with high-grade disease, as well as timing of systemic chemotherapy and surveillance protocols. 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Consensus guideline for the management of patients with appendiceal tumors, part 2: Appendiceal tumors with peritoneal involvement
Background
Appendiceal tumors comprise a heterogeneous group of tumors that frequently disseminate to the peritoneum. Management of appendiceal tumors is lacking high-quality data given their rarity and heterogeneity. In general, appendiceal tumor treatment is extrapolated in part from colorectal cancer or pooled studies, without definitive evidence of disease-specific benefit. Many practices are controversial and vary widely between institutions. A national consensus update of best management practices for appendiceal malignancies was performed to better standardize care. Herein, the authors present recommendations for the management of appendiceal tumors with peritoneal involvement.
Methods
As previously described, modified Delphi consensus was performed to update the previous 2018 Chicago Consensus guideline. Recommendations were supported by using rapid systematic reviews of key issues in surgical and systemic therapy. Key pathology concepts and recommendations were synthesized in collaboration with content experts.
Results
A consensus-based pathway was generated for any type of non-neuroendocrine appendiceal tumor with peritoneal involvement. The first round of Delphi consensus included 138 participants, of whom 133 (96%) participated in the second round, and greater than 90% consensus was achieved for all pathway blocks. Key items included recommending evaluation for cytoreduction to most patients with low-grade peritoneal disease who are surgical candidates and to many patients with high-grade disease, as well as timing of systemic chemotherapy and surveillance protocols. Common pitfalls in pathologic classification and their clinical implications are also presented.
Conclusions
These consensus recommendations provide guidance regarding the management of appendiceal tumors with peritoneal involvement, including a review of current evidence in the management of recurrent and unresectable disease.
期刊介绍：
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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