ABSTRACT

Malignancies of the appendix are a diverse group of rare gastrointestinal tumors. They constitute approximately 0.4% of all intestinal neoplasms. About 1% of all large-bowel cancers arise from the appendix. Despite the diminutive size of this organ and the infrequent occurrence of such tumors, the histopathology of appendiceal malignancy has been confusing and the approach to therapy is complex. Unfortunately, a majority of the appendiceal tumors have perforated at the time of definitive surgical treatment. In these patients, carcinomatosis is present at the time of initial surgery, although liver metastases and lymph node metastases are seldom present. To improve salvage of patients with perforated tumors and those with documented distant spread within the abdominal cavity, a new and curative approach to this previously uniformly lethal condition (the spread of tumor on peritoneal surfaces) is presented.