Chemotherapy for cancers of the appendix when surgery is not an option

This paper assessed the benefits of giving systemic (whole-body) chemotherapy in cancers of the appendix, when surgery combined with intraperitoneal chemotherapy was not an option.

Cancers of the appendix are rare, accounting for about 1% of all colon cancers. However, some of these tumors are aggressive and quickly spread to the peritoneum (the lining of the abdominal cavity). When this happens, the best course of treatment often involves surgery to remove most of the tumor (“cytoreductive surgery”) and chemotherapy given directly into the peritoneal cavity. For some patients, this therapy is not an option. In such cases, systemic chemotherapy may help control or even cure the cancer.

This paper outlined a medical center’s experience in treating appendix cancer. Out of 182 patients registered (participants had the following types of appendix cancer: mucinous carcinoma with pseudomyxoma peritonei, and/or signet ring cell carcinoma) 54 were able to receive only systemic chemotherapy. Each patient underwent two or more cycles of chemotherapy. After a median follow-up of 24 months, 55.6% of patients achieved various degrees of cancer control, varying from complete response (cure) to stable disease (no progression). The median progression-free survival (time before cancer progression) and overall survival were 7.6 months and 56 months, respectively.

These results suggest that even when surgery is not an option, systemic chemotherapy may help control the disease and prolong survival. With newer anti-cancer drugs, survival rates are expected to rise.

This study only reflected one hospital’s experience and had few participants. Due to the rarity of appendix cancers, medical literature is scarce. Therefore, deciding the best course of action can sometimes be difficult, and must be individualized.