Low-grade appendiceal mucinous neoplasm and pseudomyxoma peritonei: lines of therapy
4 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Pseudomyxoma peritonei, resectable | Complete cytoreductive surgery (peritonectomy and organ resection) with hyperthermic intraperitoneal chemotherapy, mitomycin or oxaliplatin, in a specialist centre. | NCCN Guidelines: Colon Cancer (appendiceal section) | 80 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Unresectable or recurrent disease | Repeat cytoreduction where feasible; debulking for symptoms; systemic chemotherapy only for high-grade histology; trials of mucolytics and pressurised intraperitoneal aerosol chemotherapy. | NCCN Guidelines: Colon Cancer (appendiceal section) | 83 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | LAMN confined to the appendix | Appendicectomy with clear margin; no right hemicolectomy; surveillance imaging if mucin was found outside the appendix. | NCCN Guidelines: Colon Cancer (appendiceal section) | 66 | |
| All comers | High-grade pseudomyxoma peritonei | Cytoreductive surgery with HIPEC, with perioperative systemic chemotherapy (FOLFOX or CAPOX) as for appendiceal adenocarcinoma. | NCCN Guidelines: Colon Cancer (appendiceal section) | 82 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.