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A Promising Treatment for Advanced Appendix Cancer in Select Patients

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal carcinoma with peritoneal and parenchymal metastases.DOI 10.1016j.ejso.2025.111301

Appendix cancer is rare, and it can spread to the belly (peritoneum) and organs like the liver or lungs. This advanced stage is called stage IVc. One treatment is called CRS/HIPEC. It combines surgery to remove tumors (cytoreductive surgery) with warm chemotherapy placed directly in the belly during the operation.

This study looked at almost 1,000 people with appendix cancer that had spread both inside and outside the belly. Patients either had CRS/HIPEC, surgery only, or chemotherapy. The results were hopeful—CRS/HIPEC helped people with low-grade tumors live much longer. In some cases, patients were still alive years after treatment.

The benefit was clear in both types of low-grade appendix cancer, whether the tumors made mucus (mucinous) or not. But for people with high-grade tumors (more aggressive cancer), CRS/HIPEC did not show a clear survival advantage.

This means CRS/HIPEC may be a strong option for some patients, but not for everyone. It works best in early, slower-growing forms of the disease, even if it has already spread to organs like the liver or lungs. Age, insurance, and tumor type were all linked to whether someone got this treatment.

This research gives hope to people with advanced appendix cancer. Patients with low-grade tumors can ask their doctors if CRS/HIPEC is a good fit for them.

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Dr. Harsh J Shah
Dr Harsh Shah - GI & HPB Oncosurgeon in India
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