中文标题：阑尾腺癌患者细胞根治手术与全身化疗的疗效评估 摘要：阑尾腺癌（AAs）是罕见的肿瘤，通常晚期出现，并具有腹膜转移（PMs）的倾向。本研究旨在评估接受细胞根治手术（CRS）治疗的AA患者的疗效，并确定全身化疗的作用。数据来自一个前瞻性数据库，并根据世界卫生组织（WHO）2019分类进行分类。使用完整细胞减灭度（CC）评分来描述CRS术后的肿瘤清除情况，评分范围从0（无残余病灶）到3（>2.5 cm残余病灶）。CC0-2的患者接受高温腹腔化疗（HIPEC）。全身化疗分为“先前化疗”（发生在手术前6个月以上）、“新辅助化疗”（发生在手术前6个月以内）、“辅助化疗”（发生在CC0-1 CRS术后6个月以内）和“姑息化疗”（发生在CC2-3 CRS术后）。分析使用Kaplan-Meier和Cox回归方法。从2005年1月至2021年8月，共纳入216例AA患者。年龄中位数为59岁（21-81岁）。CRS/HIPEC在182例（84%）患者中进行，其中164例/182例（76%）接受了丝裂霉素C HIPEC。172例（80%）患者达到CC0-1。全样本中有97例（45%）患者接受了全身化疗，46例阳性淋巴结患者中有37例（80%）接受了全身化疗。中位总生存期（OS）为122个月（95%置信区间61-182个月）。多变量分析后发现，无细胞粘液和低分级PM的患者与局限性（M0）疾病的患者具有类似的OS（P = 0.59和P = 0.19）。对于淋巴结阳性的患者，与未接受化疗相比，全身化疗与死亡风险降低相关（P < 0.0019）。本研究发现，淋巴结阳性的AA患者从全身化疗中获得最大益处。我们证实了分期和腹膜分级的预后重要性，并发现无细胞粘液和低分级PM的患者有良好的预后。 版权所有 © 2023 The Authors. 由Elsevier Ltd.发布。保留所有权利。

Appendix adenocarcinomas (AAs) are rare tumours that often present late, with a propensity for peritoneal metastases (PMs). This study aimed to evaluate outcomes of AA patients undergoing cytoreductive surgery (CRS) with curative intent and determine the role of systemic chemotherapy.Data were collected from a prospective database and classified according to World Health Organization (WHO) 2019 classification. Tumour clearance from CRS was described using a completeness of cytoreduction (CC) score ranging from 0 [no residual disease (RD)] to 3 (>2.5 cm RD). Patients with CC0-2 CRS received hyperthermic intraperitoneal chemotherapy (HIPEC). Systemic chemotherapy was categorised as 'prior' (>6 months before), 'neoadjuvant' (<6 months before), 'adjuvant' (<6 months after CC0-1 CRS) or 'palliative' (after CC2-3 CRS). Analyses used Kaplan-Meier and Cox regression methods.Between January 2005 and August 2021, 216 AA patients were identified for inclusion. Median age was 59 years (21-81 years). CRS/HIPEC was carried out in 182 (84%) patients, of whom 164/182 (76%) had mitomycin C HIPEC. CC0-1 was achieved in 172 (80%) patients. Systemic chemotherapy was given to 97 (45%) patients from the whole cohort and to 37/46 (80%) patients with positive nodes. Median overall survival (OS) was 122 months (95% confidence interval 61-182 months). After multivariate analysis, patients with acellular and lower-grade PM had similar OS to those with localised (M0) disease (P = 0.59 and P = 0.19). For patients with positive nodes, systemic chemotherapy was associated with reduced risk of death compared to no chemotherapy (P < 0.0019).This study identifies AA patients with positive lymph nodes derive the most benefit from systemic chemotherapy. We confirm the prognostic importance of stage and peritoneal grade, with excellent outcomes in patients with acellular mucin and lower-grade PM.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.