Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/ASO.2005.03.013
Annals of Surgical Oncology 12:72-80 (2005)
© 2005 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by González-Moreno, S.
Right arrow Articles by Sugarbaker, P. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by González-Moreno, S.
Right arrow Articles by Sugarbaker, P. H.

Original Article

Lymph Node Metastasis in Epithelial Malignancies of the Appendix With Peritoneal Dissemination Does Not Reduce Survival in Patients Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

S. González-Moreno, MD, PhD1, E. Brun, MD, FCAP, FASCP2 and P. H. Sugarbaker, MD, FACS, FRCS1

1 The Washington Cancer Institute, 106 Irving Street, Suite N3900, N.W., Washington, DC 20010, USA
2 Department of Pathology, Washington Hospital Center, Washington, DC, USA

Correspondence: Address correspondence and reprint requests to: P. H. Sugar-baker, MD, FACS, FRCS; E-mail: paul.sugarbaker{at}medstar.net

Background: Peritoneal dissemination of appendiceal malignancy combined with regional lymph node metastasis is an unusual combination of patterns of cancer dissemination.

Methods: A database of 501 appendiceal malignancy patients, all with documented peritoneal seeding, was used to identify 25 patients with involvement of the regional lymph nodes. All patients were uniformly treated with cytoreductive surgery plus perioperative intraperitoneal chemotherapy with mitomycin C and 5-fluorouracil. The clinical and pathologic features of the lymph node–positive patients were compared with those of the lymph node–negative patients. The effect of regional lymph node involvement on survival was determined. Within the group of lymph node–positive patients, clinical and pathologic features were tested for their effect on survival.

Results: When compared with patients with no apparent lymph node positivity, patients with positive lymph nodes were more likely to have an acute abdomen as the initial presentation (P < .001). The intestinal (nonmucinous) histological type was more common (P < .001), and the disseminated peritoneal adenomucinosis histology was less common (P < .001). Survival with the aggressive treatment strategy used in these patients was not different for lymph node–positive as compared with lymph node–negative patients (P = .15 by univariate and P = .38 by multivariate analysis).

Conclusions: Appendiceal malignancy with dissemination to the lymph nodes has a more acute onset and a more frequent nonmucinous histology. With aggressive treatment strategies, lymph node–positive patients did not show a statistically significantly diminished survival.

Key Words: Appendix neoplasms • Pseudomyxoma peritonei • Mucinous adenocarcinoma • Lymphatic metastasis • Peritoneal carcinomatosis






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by the Society of Surgical Oncology.