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* '''Development of new Imaging modalities'''  
* '''Development of new Imaging modalities'''  
:* CT scan, MRI as well as specific imaging modalities such as [[somatostatin]] [[scintigraphy]] revolutionized approaching to the patients with appendix cancer
:* CT scan, MRI as well as specific imaging modalities such as [[somatostatin]] [[scintigraphy]] revolutionized approaching to the patients with appendix cancer.


=== '''Future horizons''' ===
*Genetic studies revolutionized cancer treatment; appendix cancer is not an exception.
* Traditionally appandiceal cancers were approached the same as colorectal cancers. Recent genetic studies demonstrated that appendiceal tumors are clearly differ from colorectal cancers.<ref name="pmid22342786">{{cite journal| author=Levine EA, Blazer DG, Kim MK, Shen P, Stewart JH, Guy C et al.| title=Gene expression profiling of peritoneal metastases from appendiceal and colon cancer demonstrates unique biologic signatures and predicts patient outcomes. | journal=J Am Coll Surg | year= 2012 | volume= 214 | issue= 4 | pages= 599-606; discussion 606-7 | pmid=22342786 | doi=10.1016/j.jamcollsurg.2011.12.028 | pmc=3768122 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22342786  }} </ref>
** Presence of mutated [[TP53]] and APC genes were significantly lower in appendiceal cancers compared to colorectal cancers.
* It has been shown that mutation profiles are associated with the patients’ prognosis. <ref name="pmid26821970">{{cite journal| author=Levine EA, Votanopoulos KI, Qasem SA, Philip J, Cummins KA, Chou JW et al.| title=Prognostic Molecular Subtypes of Low-Grade Cancer of the Appendix. | journal=J Am Coll Surg | year= 2016 | volume= 222 | issue= 4 | pages= 493-503 | pmid=26821970 | doi=10.1016/j.jamcollsurg.2015.12.012 | pmc=4808611 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26821970  }} </ref>
** Mutations in the TP53 significantly decrease life expectancy in patients with appendix cancer. 
** Regardless of tumor grade, Tp 53 mutations were associated with poorer outcomes.
** Patients with GNAS mutations had a life expectancy of 10 years after diagnosis.
** Appendiceal tumors with GNAS mutations rarely develop into high-grade tumors.


===Famous Cases===
===Famous Cases===
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Surgery]]
[[Category:Medicine]]
[[Category:Emergency medicine]]
[[Category:Oncology]]
[[Category:Up-To-Date]]

Latest revision as of 17:41, 22 February 2019

Appendix cancer Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

Appendix cancer was first described in the published literature by Sir George Thos. Beatson, an English surgeon, in 1913. Development of surgical sciences revolutionized cancer care, appendix cancer was not an exception. Introduction of chemotherapy agents such as 5-fluorouracil (5-FU), irinotecan, oxaliplatin, vascular endothelial growth factor receptor inhibitors (bevacizumab), epidermal growth factor receptor inhibitors (cetuximab and panitumumab), aflibercept, regorafenib, inhibitor of angiogenic tyrosine kinases (including the VEGF receptors 1, 2,and 3), capecitabine as well as introduction of intraperitoneal chemotherapy including hyperthermic intraperitoneal chemotherapyadvanced appendix cancer treatment. Development of new Imagingmodalities such as CT scan, MRI as well as specific imaging modalities such as somatostatin scintigraphy also transfigured approaching to the patients with appendix cancer. Genetic studies introduced novel horizons in approaching patients with appendix cancer.

Historical Perspective

Discovery

  • Appendix cancer was first described in the published literature by Sir George Thos. Beatson, an English surgeon, in 1913.[1]

Landmark Events in the Development of Treatment Strategies

  • Surgical sciences development
  • First recorded appendectomy performed on December 6, 1735, at St. George's Hospital in London.[2]
  • First reported anesthesia (December 1846. Ether anesthesia, Paris, France), although traditionally Persian surgeons such as Razi prescribed wine to sedate their patients before painful procedures.[3]
  • First laparoscopic operation in humans performed by Swedish surgeon, Hans Christian Jacobaeus, on 1910 in Stockholm.[4]
  • Chemotherapy
  • Introduction of 5-fluorouracil (5-FU) the first coorectal chemotherapy agent, 1957.[5]
  • Introduction of Octereotide analogs to control symptoms of carcinoid syndrome.[6]
  • Intraperitoneal chemotherapy including hyperthermic intraperitoneal chemotherapy plus/minus early postoperative intraperitoneal chemotherapy (EPIC) by Spratt et al. in the 1980s.[7]
  • Development of new chemotherapy agents (1990s) such as:
  • Development of new Imaging modalities
  • CT scan, MRI as well as specific imaging modalities such as somatostatin scintigraphy revolutionized approaching to the patients with appendix cancer.


Famous Cases

The following are a few famous cases of appendix cancer:

  • Celebrated actress, Audrey Hepburn was the most famous victims of appendix cancer, she passed away in 1993.[10]
  • Stuart Scott, ESPN sportscast anchor was diagnosed with appendix cancer in 2007 and died 8 years later in 2015.[11][12]

References

  1. Beatson GT (1913) Note on a Case of Carcinoma of the Vermiform Appendix in a Girl, Aged 20 Years. Glasgow Med J 80 (6):418-422. PMID: 30435413
  2. Meljnikov I, Radojcić B, Grebeldinger S, Radojcić N (2009) [History of surgical treatment of appendicitis.] Med Pregl 62 (9-10):489-92. PMID: 20391748
  3. Robinson DH, Toledo AH (2012) Historical development of modern anesthesia. J Invest Surg 25 (3):141-9. DOI:10.3109/08941939.2012.690328 PMID: 22583009
  4. Hatzinger M, Kwon ST, Langbein S, Kamp S, Häcker A, Alken P (2006) Hans Christian Jacobaeus: Inventor of human laparoscopy and thoracoscopy. J Endourol 20 (11):848-50. DOI:10.1089/end.2006.20.848 PMID: 17144849
  5. HEIDELBERGER C, CHAUDHURI NK, DANNEBERG P, MOOREN D, GRIESBACH L, DUSCHINSKY R et al. (1957) Fluorinated pyrimidines, a new class of tumour-inhibitory compounds. Nature 179 (4561):663-6. PMID: 13418758
  6. Pless J (2005) The history of somatostatin analogs. J Endocrinol Invest 28 (11 Suppl International):1-4. PMID: 16625837
  7. Spratt JS, Adcock RA, Muskovin M, Sherrill W, McKeown J (1980) Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Cancer Res 40 (2):256-60. PMID: 6766084
  8. "www.accessdata.fda.gov" (PDF).
  9. "www.accessdata.fda.gov" (PDF).
  10. "Audrey Hepburn Appendix Cancer".
  11. "Stuart Scott's Battle With Cancer".
  12. "Stuart Scott, ESPN's Voice of Exuberance, Dies at 49 - The New York Times".