The Chicago Consensus on peritoneal surface malignancies: management of appendiceal neoplasms
A multidisciplinary consensus laying out treatment pathways for each kind of appendix tumour, from low-grade mucinous neoplasms to adenocarcinoma and goblet cell adenocarcinoma, including when cytoreductive surgery with heated chemotherapy and when systemic chemotherapy are appropriate.
Overview
Consensus from the Chicago Consensus Working Group of surgical, medical and pathological oncologists giving management algorithms for appendiceal neoplasms: LAMN with and without peritoneal disease, high-grade mucinous neoplasm, mucinous and non-mucinous adenocarcinoma, and goblet cell adenocarcinoma.
It recommends cytoreductive surgery with HIPEC for peritoneal disease in centres with expertise, systemic chemotherapy based on colorectal regimens for high-grade and adenocarcinoma histologies, and observation for low-grade disease confined to the appendix.
The standard-of-care rows on the appendiceal pages, particularly who is referred for cytoreductive surgery and who receives chemotherapy, follow this consensus and the NCCN appendiceal section.
- Consensus on limited retrospective evidence; no randomised trial has tested chemotherapy in appendiceal adenocarcinoma at the time of writing.
- Applies to centres with peritoneal surface malignancy expertise.
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