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Trecourt A, Bakrin N, Glehen O, Gertych W, Villeneuve L, Kepenekian V, Devouassoux-Shisheboran M. ASO Author Reflections: Pseudomyxoma Peritonei of Ovarian Origin-Modern Approach and Perspectives. Ann Surg Oncol 2024; 31:2755-2756. [PMID: 38200386 DOI: 10.1245/s10434-024-14927-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Alexis Trecourt
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Pathologie, Lyon, France
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
| | - Naoual Bakrin
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
- Service de Chirurgie Digestive, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Olivier Glehen
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
- Service de Chirurgie Digestive, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Witold Gertych
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
- Service de Gynécologie, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Laurent Villeneuve
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
- Service de Chirurgie Digestive, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Vahan Kepenekian
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France
- Service de Chirurgie Digestive, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Mojgan Devouassoux-Shisheboran
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service de Pathologie, Lyon, France.
- UR3738 - Centre pour l'Innovation en Cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1, Lyon, France.
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Fransvea P, Puccioni C, Altieri G, D'Agostino L, Costa G, Tropeano G, La Greca A, Brisinda G, Sganga G. Beyond acute appendicitis: a single-institution experience of unexpected pathology findings after 989 consecutive emergency appendectomy. Langenbecks Arch Surg 2024; 409:87. [PMID: 38441707 DOI: 10.1007/s00423-024-03277-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Appendiceal neoplasms (ANs) are rare, with an estimated incidence of around 1%: neuroendocrine tumours (NETs) and low-grade appendiceal mucinous neoplasms (LAMNs) comprise most cases. Most tumours are cured by appendectomy alone, although some require right hemicolectomy and intra-operative chemotherapy. The aim of the present study is to evaluate our institution's experience in terms of the prevalence of AN, their histological types, treatment and outcomes in adult patients undergoing emergency appendectomy. MATERIAL AND METHODS Single-centre retrospective cohort analysis of patients treated for acute appendicitis at a large academic medical centre. Patients with a diagnosis of acute appendicitis (AA) where further compared with patients with acute appendicitis and a histologically confirmed diagnosis of appendiceal neoplasm (AN). RESULTS A diagnosis of acute appendicitis was made in 1200 patients. Of these, 989 patients underwent emergency appendectomy. The overall incidence of appendiceal neoplasm was 9.3% (92 patients). AN rate increased with increasing age. Patients under the age of 30 had a 3.8% (14/367 patients) rate of occult neoplasm, whereas patients between 40 and 89 years and older had a 13.0% rate of neoplasm. No difference was found in clinical presentations and type of approach while we found a lower complicated appendicitis rate in the AN group. CONCLUSION ANs are less rare with respect to the literature; however, clinically, there are no specific signs of suspicious and simple appendicectomy appears to be curative in most cases. However, age plays an important role; older patients are at higher risk for AN. ANs still challenge the non-operative management concept introduced into the surgical literature.
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Affiliation(s)
- Pietro Fransvea
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy.
- Università Cattolica del Sacro Cuore Roma Italia, Rome, Italy.
| | - Caterina Puccioni
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
- Università Cattolica del Sacro Cuore Roma Italia, Rome, Italy
| | - Gaia Altieri
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
| | - Luca D'Agostino
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
| | - Gianluca Costa
- Surgery Center, Colorectal Surgery Clinical and Research Unit - Fondazione Policlinico Universitario Campus Bio-Medico, University Campus Bio-Medico of Rome, Rome, Italy
| | - Giuseppe Tropeano
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
| | - Antonio La Greca
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
- Università Cattolica del Sacro Cuore Roma Italia, Rome, Italy
| | - Giuseppe Brisinda
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
- Università Cattolica del Sacro Cuore Roma Italia, Rome, Italy
| | - Gabriele Sganga
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Rome, Italy
- Università Cattolica del Sacro Cuore Roma Italia, Rome, Italy
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Ma R, Su Y, Yan F, Lin Y, Gao Y, Li Y. A nomogram prediction model of pseudomyxoma peritonei established based on new prognostic factors of HE stained pathological images analysis. Cancer Med 2024; 13:e7101. [PMID: 38506243 PMCID: PMC10952024 DOI: 10.1002/cam4.7101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/13/2024] [Accepted: 03/02/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare clinical malignant syndrome, and its rarity causes a lack of pathology research. This study aims to quantitatively analyze HE-stained pathological images (PIs), and develop a new predictive model integrating digital pathological parameters with clinical information. METHODS Ninety-two PMP patients with complete clinic-pathological information, were included. QuPath was used for PIs quantitative feature analysis at tissue-, cell-, and nucleus-level. The correlations between overall survival (OS) and general clinicopathological characteristics, and PIs features were analyzed. A nomogram was established based on independent prognostic factors and evaluated. RESULTS Among the 92 PMP patients, there were 34 (37.0%) females and 58 (63.0%) males, with a median age of 57 (range: 31-76). A total of 449 HE stained images were obtained for QuPath analysis, which extracted 40 pathological parameters at three levels. Kaplan-Meier survival analysis revealed eight clinicopathological characteristics and 20 PIs features significantly associated with OS (p < 0.05). Partial least squares regression was used to screen the multicollinearity features and synthesize four new features. Multivariate survival analysis identified the following five independent prognostic factors: preoperative CA199, completeness of cytoreduction, histopathological type, component one at tissue-level, and tumor nuclei circularity variance. A nomogram was established with internal validation C-index 0.795 and calibration plots indicating improved prediction performance. CONCLUSIONS The quantitative analysis of HE-stained PIs could extract the new prognostic information on PMP. A nomogram established by five independent prognosticators is the first model integrating digital pathological information with clinical data for improved clinical outcome prediction.
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Affiliation(s)
- Ru Ma
- Department of Peritoneal Cancer Surgery, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Yan‐Dong Su
- Department of Peritoneal Cancer Surgery, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Feng‐Cai Yan
- Department of Pathology, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Yu‐Lin Lin
- Department of Peritoneal Cancer Surgery, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Ying Gao
- Department of Pathology, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Yan Li
- Department of Peritoneal Cancer Surgery, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
- Department of Surgical OncologyBeijing Tsinghua Changgung Hospital Affiliated to Tsinghua UniversityBeijingChina
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Han Z, Liu X, Tian Y, Shen S, Wang H, Hu S, Wu X, Yan Z, Lu C, Wang P, Bai Y, Kong Y, Wang L, Cao S, Li Z, Zhong H, Meng C, Zhou Y. Long term survival outcomes of surgery combined with hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms: A multicenter retrospective study. World J Surg 2024; 48:86-96. [PMID: 38686746 DOI: 10.1002/wjs.12018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/17/2023] [Indexed: 05/02/2024]
Abstract
BACKGROUND Low-grade appendiceal mucinous neoplasms (LAMN) are very rare, accounting for approximately 0.2%-0.5% of gastrointestinal tumors. We conducted a multicenter retrospective study to explore the impact of different surgical procedures combined with HIPEC on the short-term outcomes and long-term survival of patients. METHODS We retrospectively analyzed the clinicopathological data of 91 LAMN perforation patients from 9 teaching hospitals over a 10-year period, and divided them into HIPEC group and non-HIPEC group based on whether or not underwent HIPEC. RESULTS Of the 91 patients with LAMN, 52 were in the HIPEC group and 39 in the non-HIPEC group. The Kaplan-Meier method predicted that 52 patients in the HIPEC group had 5- and 10-year overall survival rates of 82.7% and 76.9%, respectively, compared with predicted survival rates of 51.3% and 46.2% for the 39 patients in the non-HIPEC group, with a statistically significant difference between the two groups (χ2 = 10.622, p = 0.001; χ2 = 10.995, p = 0.001). Compared to the 5-year and 10-year relapse-free survival rates of 75.0% and 65.4% in the HIPEC group, respectively, the 5-year and 10-year relapse-free survival rates of 48.7% and 46.2% in the non-HIPEC group were significant different between the two outcomes (χ2 = 8.063, p = 0.005; χ2 = 6.775, p = 0.009). The incidence of postoperative electrolyte disturbances and hypoalbuminemia was significantly higher in the HIPEC group than in the non-HIPEC group (p = 0.023; p = 0.044). CONCLUSIONS This study shows that surgery combined with HIPEC can significantly improve 5-year and 10-year overall survival rates and relapse-free survival rates of LAMN perforation patients, without affecting their short-term clinical outcomes.
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Affiliation(s)
- Zhenlong Han
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaodong Liu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yulong Tian
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Shuai Shen
- Department of Colorectal Surgery, Weifang People's Hospital, Weifang, Shandong, China
| | - Hongbo Wang
- Department of Gastrointestinal Surgery, The People's Hospital of Jimo Qingdao, Qingdao, Shandong, China
| | - Shuiqing Hu
- Department of Gastrointestinal Surgery, The People's Hospital of Jimo Qingdao, Qingdao, Shandong, China
| | - Xudong Wu
- Department of Gastrointestinal Surgery, The People's Hospital of Dongying Shandong, Dongying, Shandong, China
| | - Zhao Yan
- Department of Gastrointestinal Surgery, The People's Hospital of Dongying Shandong, Dongying, Shandong, China
| | - Cunlong Lu
- Department of Gastrointestinal Surgery, Juxian People's Hospital, Rizhao, Shandong, China
| | - Peixin Wang
- General Surgery Department, Qingdao Hospital University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong, China
| | - Yingcheng Bai
- General Surgery Department, 971st Naval Hospital, Qingdao, Shandong, China
| | - Ying Kong
- General Surgery Department, Jining No 1 People's Hospital, Jining, Shandong, China
| | - Liankai Wang
- Department of Gastrointestinal Surgery, Weifang Yidu Central Hospital, Weifang, Shandong, China
| | - Shougen Cao
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zequn Li
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hao Zhong
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Cheng Meng
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yanbing Zhou
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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