Download PDF
CC BY 4.0 · Journal of Coloproctology 2024; 44(01): e41-e46
DOI: 10.1055/s-0044-1779601
Original Article

Appendiceal Goblet Cell Carcinoma: Comparison of Classification and Staging Systems with Evaluation of the Prognostic Role of Immunohistochemistry Stains

Rachel Masia
1   Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ, United States
,
Vincent Marcucci 
1   Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ, United States
,
Colton Moore
2   Department of Surgery, Division of Colon and Rectal Surgery, School of Medicine, St. George's University, St. George's Grenada, West Indies, Grenada
,
Xiu Sun
3   Department of Pathology, Jersey Shore University Medical Center, Neptune, NJ, United States
,
Arthur Topilow
3   Department of Pathology, Jersey Shore University Medical Center, Neptune, NJ, United States
,
Timothy Gelatt
3   Department of Pathology, Jersey Shore University Medical Center, Neptune, NJ, United States
,
Glenn Parker
1   Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ, United States
2   Department of Surgery, Division of Colon and Rectal Surgery, School of Medicine, St. George's University, St. George's Grenada, West Indies, Grenada
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Background Goblet cell carcinoma (GCC) of the appendix is a unique lesion that exhibits features of both adenocarcinoma and neuroendocrine tumors. Due to the rarity of this cancer, multiple grading (e.g., Tang, Yozu, and Lee) and staging systems (e.g., tumor, lymph nodes, and metastasis [TNM]) have been developed for classification. This study aimed to compare commonly used classification systems and evaluate the prognostic effectiveness immunohistochemical staining may or may not have for appendiceal GCC.

Methods An electronic medical records review of patients who were diagnosed with GCC of the appendix in our hospital system from 2010 to 2020. The data were collected regarding the age at diagnosis, gender, initial diagnosis at presentation, operation(s) performed, final pathology results, current survival status, and year of recurrent disease or death year.

Results Ten patients were evaluated. Seventy percent of the patients were above the age of 50 years at diagnosis. Postdischarge survival ranged from 1 month to 109 months postdiagnosis. Two patients expired from GCC at 13- and 54-months following diagnosis. When comparing the classification systems, Lee categorized more patients as high risk than Tang and Yozu. Immunohistochemical staining was analyzed using four staining methods: Ki67, E-cadherin, Beta-catenin, and p53. Tumor, lymph nodes, and metastasis staging has supportive evidence for worsening prognosis and overall survival secondary to the depth of invasion of the tumor.

Conclusion Tumor, lymph nodes, and metastasis staging may be superior to the other classification systems in predicting overall mortality. Our study demonstrated that immunohistochemistry staining does not appear to have a significant impact in determining the prognosis for GCC of the appendix.

Keywords

general surgery - colorectal - appendiceal cancer - goblet cell cancer - surgical oncology

Disclosures

None.




Publication History

Received: 07 December 2023

Accepted: 10 January 2024

Article published online:
11 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 McCusker ME, Coté TR, Clegg LX, Sobin LH. Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973-1998. Cancer 2002; 94 (12) 3307-3312
    CrossrefPubMedGoogle Scholar
  • 2 Ramnani DM, Wistuba II, Behrens C, Gazdar AF, Sobin LH, Albores-Saavedra J. K-ras and p53 mutations in the pathogenesis of classical and goblet cell carcinoids of the appendix. Cancer 1999; 86 (01) 14-21
    CrossrefPubMedGoogle Scholar
  • 3 Palmer K, Weerasuriya S, Chandrakumaran K. et al. Goblet Cell Adenocarcinoma of the Appendix: A Systematic Review and Incidence and Survival of 1,225 Cases From an English Cancer Registry. Front Oncol 2022; 12: 915028
    CrossrefPubMedGoogle Scholar
  • 4 Rossi RE, Luong TV, Caplin ME. et al. Goblet cell appendiceal tumors–management dilemmas and long-term outcomes. Surg Oncol 2015; 24 (01) 47-53
    CrossrefPubMedGoogle Scholar
  • 5 Tang LH, Shia J, Soslow RA. et al. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol 2008; 32 (10) 1429-1443
    CrossrefPubMedGoogle Scholar
  • 6 Pahlavan PS, Kanthan R. Goblet cell carcinoid of the appendix. World J Surg Oncol 2005; 3: 36 DOI: 10.1186/1477-7819-3-36.
    CrossrefPubMedGoogle Scholar
  • 7 Burgart L, Chopp W, Jain D. et al. Protocol for the Examination of Specimens from Patients With Carcinoma of the Appendix. CAP 2021; ; (June): 1-19
    Google Scholar
  • 8 Yozu M, Johncilla ME, Srivastava A. et al. Histologic and Outcome Study Supports Reclassifying Appendiceal Goblet Cell Carcinoids as Goblet Cell Adenocarcinomas, and Grading and Staging Similarly to Colonic Adenocarcinomas. Am J Surg Pathol 2018; 42 (07) 898-910
    CrossrefPubMedGoogle Scholar
  • 9 Lee LH, McConnell YJ, Tsang E. et al. Simplified 2-tier histologic grading system accurately predicts outcomes in goblet cell carcinoid of the appendix. Hum Pathol 2015; 46 (12) 1881-1889
    CrossrefPubMedGoogle Scholar
  • 10 Edge SB. Appendix. In: AJCC cancer staging manual., editor. 7th ed. New York:: Springer;; 2010. . pp. 133-138
    Google Scholar
  • 11 Wen KW, Hale G, Shafizadeh N, Hosseini M, Huang A, Kakar S. Appendiceal goblet cell carcinoid: common errors in staging and clinical interpretation with a proposal for an improved terminology. Hum Pathol 2017; 65: 187-193
    CrossrefPubMedGoogle Scholar
  • 12 Wang HL, Dhall D. Goblet or signet ring cells: that is the question. Adv Anat Pathol 2009; 16 (04) 247-254
    CrossrefPubMedGoogle Scholar
  • 13 Nagtegaal ID, Odze RD, Klimstra D. et al; WHO Classification of Tumours Editorial Board. The 2019 WHO classification of tumours of the digestive system. Histopathology 2020; 76 (02) 182-188 DOI: 10.1111/his.13975.
    CrossrefPubMedGoogle Scholar
  • 14 Li LT, Jiang G, Chen Q, Zheng JN. Ki67 is a promising molecular target in the diagnosis of cancer (review). (Review) Mol Med Rep 2015; 11 (03) 1566-1572
    CrossrefPubMedGoogle Scholar
  • 15 Shang S, Hua F, Hu ZW. The regulation of β-catenin activity and function in cancer: therapeutic opportunities. Oncotarget 2017; 8 (20) 33972-33989
    CrossrefPubMedGoogle Scholar
  • 16 Petrova YI, Schecterson L, Gumbiner BM. Roles for E-cadherin cell surface regulation in cancer. Mol Biol Cell 2016; 27 (21) 3233-3244
    CrossrefPubMedGoogle Scholar
  • 17 Martin TA, Ye L, Sanders AJ. et al. Cancer Invasion and Metastasis: Molecular and Cellular Perspective. Madame Curie Bioscience Database. 2000–2013.
    Google Scholar
  • 18 Mantovani F, Collavin L, Del Sal G. Mutant p53 as a guardian of the cancer cell. Cell Death Differ 2019; 26 (02) 199-212
    CrossrefPubMedGoogle Scholar
  • 19 Duraiyan J, Govindarajan R, Kaliyappan K, Palanisamy M. Applications of immunohistochemistry. J Pharm Bioallied Sci 2012; 4 (Suppl. 02) S307-S309 DOI: 10.4103/0975-7406.100281.
    CrossrefPubMedGoogle Scholar