Peritoneal carcinomatosis from appendiceal cancer: A paradigm for treatment of abdomino-pelvic dissemination of gastrointestinal malignancy

Summary Background Peritoneal carcinomatosis from appendix cancer is a rare disease which has generally not been studied. 104 patients treated by a uniform treatment strategy have been followed for up to 10 years. Methods The clinical features that correlate with improved survival included low vs. high histologic grade, complete vs. incomplete cytoreduction, lymph nodes negative rather than positive for metastasis and minimal vs. extensive prior surgery. By the Cox semi-parametric model the independent variables were histologic grade and completeness of cytoreduction. From these data prognostic groups 1, 2 and 3 were formulated. Results Patients in prognostic group 1 had a complete cytoreduction and a grade 1 histopathology with a 5 year survival of 90%. Patients in prognostic group 2 had a complete cytoreduction with grade 2 or 3 histopathology and a 70% 5 year survival. Patients in group 3 had an incomplete cytoreduction, and a 5 year survival of 22%. Conclusions These data accumulated on patients with appendix cancer may have relevance to the management of patients with peritoneal carcinomatosis from other gastrointestinal cancers.