Primary Adenocarcinoma of the Appendix

appendix is by Berger in 1882. It is most commonly classified into colonic-type adenocarcinoma and mucinous-type adenocarcinoma, which is differentiated by the production of mucin. For a perforated mucinous adenocarcinoma, intraperitoneal gelatinous material is termed “pseudomyxoma peritonei” because the material is not composed of true mucin. Primary adenocarcinoma of the appendix is a rare disease, accounting for 0.2-0.5% of all gastrointestinal tumors and 4-6% of primary malignant neoplasms of the appendix. Over the years, institutions around the world have published their treatment results for appendiceal cancer but conclusions are still controversial. Traditionally, major debulking surgery with intravenous chemotherapy has been used to treat patients with pseudomyxoma peritonei. Since Sugarbaker’s publication of peritonectomy procedure in 1987 and 1995, the treatment strategy is gradually replaced by cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy. Many institutions around the world have tried to replicate their results, including institutions in England, Australia, Italy, France, Netherland, and the United States. To evaluate the treatment result, we perform a retrospective chart review of the 15 year experience of treating primary adenocarcinoma of the appendix at National Cheng Kung University Hospital.