Outcomes of Low-Grade Appendiceal Mucinous Neoplasms with Remote Acellular Mucinous Peritoneal Deposits

Ann Surg Oncol. 2019 Jan;26(1):118-124. doi: 10.1245/s10434-018-7003-7. Epub 2018 Nov 12.


Background: Occasionally, low-grade appendiceal mucinous neoplasms (LAMN) present with mucinous peritoneal deposits (MPD) localized to periappendiceal tissue or diffused throughout the peritoneum.

Objective: This study was aimed at evaluating the relevance of mucin cellularity for predicting outcomes of LAMN with remote MPD.

Methods: The records of patients with LAMN and remote MPD who underwent initial assessment at a comprehensive cancer center from 1990 to 2015 were reviewed, and diagnostic procedures, treatments, and outcomes were analyzed.

Results: Of 48 patients included in the analysis, 19 had cellular MPD (CMPD) and 29 had acellular MPD. Of 33 patients who underwent cytoreductive surgery, 30 had a complete cytoreduction; the 3 patients with an incomplete cytoreduction had CMPD. In the follow-up period (median, 4 years), 6 patients died of the disease, all of whom had CMPD. Of 11 patients who had progression of disease, 10 had CMPD.

Conclusion: Cellularity of remote MPD is an important determinant of disease outcome in LAMN. Approaches such as active surveillance may have a role in selected patients with LAMN and AMPD.

MeSH terms

  • Adenocarcinoma, Mucinous / mortality*
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / surgery
  • Aged
  • Appendiceal Neoplasms / mortality*
  • Appendiceal Neoplasms / pathology
  • Appendiceal Neoplasms / surgery
  • Cytoreduction Surgical Procedures / mortality*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Peritoneal Neoplasms / mortality*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery
  • Survival Rate