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PTU-133 Goblet Cell Carcinoma of the Appendix: Acute vs Chronic Presentations
  1. R Basuroy1,
  2. A Ngu1,
  3. L Mills2,
  4. H El-Mahallawi3,
  5. T Cecil4,
  6. J K Ramage1,2
  1. 1Department of Gastroenterology, Hampshire Hospitals NHS Trust, Basingstoke
  2. 2Neuroendocrine Tumour Service, Institute of Liver Studies, Kings College Hospital, London
  3. 3Department of Pathology
  4. 4Pseudomyxoma peritonei Service, Hampshire Hospitals NHS Trust, Basingstoke, UK

Abstract

Introduction Goblet Cell Carcinomas (GCC) are a rare neuroendocrine tumour (NET) of the appendix. The experience of a National Specialist Centre’s for pseudomyxoma peritonei (cytoreductive surgery) and two regional NET services with patients with GCC are presented.

Methods A retrospective audit was performed of patients with histologically proven GCC collated from histology, NET and cytoreductive surgery databases. Mortality rates (%) for subgroups were calculated.

Results 16 patients (female = 9) were included for analysis with median age at diagnosis of 58 years (range, 25.5–71.8). The mortality rate was 25% (n = 4) associated with median survival of 22 months (range, 9–72) following diagnosis. The most common symptoms were acute appendicitis-like (62.5%), chronic abdominal pain (50%), bowel obstruction (25%) and chronic diarrhoea (12.5%). Patients presenting with acute appendicitis-like symptoms had the lowest mortality rate at 10%. Bowel obstruction, chronic abdominal pain and chronic diarrhoea were associated with mortality rates of 50%, 38% and 50% respectively. Completion right hemicolectomy (n = 10) was associated with decreased mortality (22% vs 40%). Bilateral salphingo-oophrectomy (n = 5) was associated with increased mortality (66% vs 0%). The mortality rate associated with chemotherapy (n = 6) and cytoreductive surgery (n = 4) was 17% and 50% respectively.

Conclusion Patients with GCC who present acutely have better outcomes than those with chronic symptoms suggesting different disease processes. Performing a completion right hemicolectomy is associated with benefit, while the role of BSO is less clear.

Disclosure of Interest None Declared

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