Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei)
Background Appendiceal mucinous neoplasms (AMNs) with disseminated disease (pseudomyxoma peritonei) are heterogeneous tumors with variable clinicopathologic behavior. Despite the development of prognostic systems, objective biomarkers are needed to stratify patients. With the advent of next-generati...
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| Veröffentlicht in: | Annals of surgical oncology 2023-11, Vol.30 (12), p.7517-7526 |
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| creator | Wald, Abigail I. Pingpank, James F. Ongchin, Melanie Hall, Lauren B. Jones, Heather Altpeter, Shannon Liebdzinski, Michelle Hamed, Ahmed B. Derby, Joshua Nikiforova, Marina N. Bell, Phoenix D. Paniccia, Alessandro Zureikat, Amer H. Gorantla, Vikram C. Rhee, John C. Thomas, Roby Bartlett, David L. Smith, Katelyn Henn, Patrick Theisen, Brian K. Shyu, Susan Shalaby, Akram Choudry, M. Haroon A. Singhi, Aatur D. |
| description | Background
Appendiceal mucinous neoplasms (AMNs) with disseminated disease (pseudomyxoma peritonei) are heterogeneous tumors with variable clinicopathologic behavior. Despite the development of prognostic systems, objective biomarkers are needed to stratify patients. With the advent of next-generation sequencing (NGS), it remains unclear if molecular testing can improve the evaluation of disseminated AMN patients.
Methods
Targeted NGS was performed for 183 patients and correlated with clinicopathologic features to include American Joint Committee on Cancer/World Health Organization (AJCC/WHO) histologic grade, peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, and overall survival (OS).
Results
Genomic alterations were identified for 179 (98%) disseminated AMNs. Excluding mitogen-activated protein kinase genes and
GNAS
due to their ubiquitous nature, collective genomic alterations in
TP53
,
SMAD4
,
CDKN2A
, and the mTOR genes were associated with older mean age, higher AJCC/WHO histologic grade, lymphovascular invasion, perineural invasion, regional lymph node metastasis, and lower mean PCI (
p
|
| doi_str_mv | 10.1245/s10434-023-13721-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2825809229</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2874648769</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-e35148859e707bdd7fb5dbe1ddccae64ec56a81e5d2962872ca26b6169ff821c3</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhSMEoqXwAiyQJTZlEfB_nGXVQlupwJUo68ixJ7euEjvYDvS-CM-Lb1NAYsFqRjPfnJnRqaqXBL8llIt3iWDOeI0pqwlrKKl3j6pDIkqJS0UelxxLVbdUioPqWUq3GJOGYfG0OmANI1xwclj9vNZxCxks-gR3uT4HD1FnFzz6At8W8Mb5Lbqc5hi-Q0L5BtAmhq0PKTuzcmFAm5KBzwn9cPkGnbmUYHJe71VP5hm8dQb0iD4uRS0sqawK86jTlNDxJsFiw7S7C5NGG4guBw_uzfPqyaDHBC8e4lH19cP769OL-urz-eXpyVVtGJW5BiYIV0q00OCmt7YZemF7INYao0FyMEJqRUBY2kqqGmo0lb0ksh0GRYlhR9XxqlseLO-m3E0uGRhH7aFc2lFFhcItpW1BX_-D3oYl-nJdoRouuWrknqIrZWJIKcLQzdFNOu46gru9a93qWldc6-5d63Zl6NWD9NJPYP-M_LapAGwFUmn5LcS_u_8j-wukc6av</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2874648769</pqid></control><display><type>article</type><title>Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei)</title><source>Springer Nature - Complete Springer Journals</source><creator>Wald, Abigail I. ; Pingpank, James F. ; Ongchin, Melanie ; Hall, Lauren B. ; Jones, Heather ; Altpeter, Shannon ; Liebdzinski, Michelle ; Hamed, Ahmed B. ; Derby, Joshua ; Nikiforova, Marina N. ; Bell, Phoenix D. ; Paniccia, Alessandro ; Zureikat, Amer H. ; Gorantla, Vikram C. ; Rhee, John C. ; Thomas, Roby ; Bartlett, David L. ; Smith, Katelyn ; Henn, Patrick ; Theisen, Brian K. ; Shyu, Susan ; Shalaby, Akram ; Choudry, M. Haroon A. ; Singhi, Aatur D.</creator><creatorcontrib>Wald, Abigail I. ; Pingpank, James F. ; Ongchin, Melanie ; Hall, Lauren B. ; Jones, Heather ; Altpeter, Shannon ; Liebdzinski, Michelle ; Hamed, Ahmed B. ; Derby, Joshua ; Nikiforova, Marina N. ; Bell, Phoenix D. ; Paniccia, Alessandro ; Zureikat, Amer H. ; Gorantla, Vikram C. ; Rhee, John C. ; Thomas, Roby ; Bartlett, David L. ; Smith, Katelyn ; Henn, Patrick ; Theisen, Brian K. ; Shyu, Susan ; Shalaby, Akram ; Choudry, M. Haroon A. ; Singhi, Aatur D.</creatorcontrib><description>Background
Appendiceal mucinous neoplasms (AMNs) with disseminated disease (pseudomyxoma peritonei) are heterogeneous tumors with variable clinicopathologic behavior. Despite the development of prognostic systems, objective biomarkers are needed to stratify patients. With the advent of next-generation sequencing (NGS), it remains unclear if molecular testing can improve the evaluation of disseminated AMN patients.
Methods
Targeted NGS was performed for 183 patients and correlated with clinicopathologic features to include American Joint Committee on Cancer/World Health Organization (AJCC/WHO) histologic grade, peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, and overall survival (OS).
Results
Genomic alterations were identified for 179 (98%) disseminated AMNs. Excluding mitogen-activated protein kinase genes and
GNAS
due to their ubiquitous nature, collective genomic alterations in
TP53
,
SMAD4
,
CDKN2A
, and the mTOR genes were associated with older mean age, higher AJCC/WHO histologic grade, lymphovascular invasion, perineural invasion, regional lymph node metastasis, and lower mean PCI (
p
< 0.040). Patients harboring
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or mTOR gene alterations were found to have lower OS rates of 55% at 5 years and 14% at 10 years, compared with 88% at 5 years and 88% at 10 years for patients without the aforementioned alterations (
p
< 0.001). Based on univariate and multivariate analyses, genomic alterations in
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or the mTOR genes in disseminated AMNs were a negative prognostic factor for OS and independent of AJCC/WHO histologic grade, PCI, CC score, and hyperthermic intraperitoneal chemotherapy treatment (
p
= 0.006).
Conclusions
Targeted NGS improves the prognostic assessment of patients with disseminated AMNs and identifies patients who may require increased surveillance and/or aggressive management.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-023-13721-y</identifier><identifier>PMID: 37314541</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Chemotherapy ; Genomics ; Kinases ; Lymph nodes ; MAP kinase ; Medicine ; Medicine & Public Health ; Metastases ; Next-generation sequencing ; Oncology ; p53 Protein ; Smad4 protein ; Surgery ; Surgical Oncology ; TOR protein ; Translational Research ; Tumors</subject><ispartof>Annals of surgical oncology, 2023-11, Vol.30 (12), p.7517-7526</ispartof><rights>Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Society of Surgical Oncology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-e35148859e707bdd7fb5dbe1ddccae64ec56a81e5d2962872ca26b6169ff821c3</cites><orcidid>0000-0003-3930-7096</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-023-13721-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-023-13721-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37314541$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wald, Abigail I.</creatorcontrib><creatorcontrib>Pingpank, James F.</creatorcontrib><creatorcontrib>Ongchin, Melanie</creatorcontrib><creatorcontrib>Hall, Lauren B.</creatorcontrib><creatorcontrib>Jones, Heather</creatorcontrib><creatorcontrib>Altpeter, Shannon</creatorcontrib><creatorcontrib>Liebdzinski, Michelle</creatorcontrib><creatorcontrib>Hamed, Ahmed B.</creatorcontrib><creatorcontrib>Derby, Joshua</creatorcontrib><creatorcontrib>Nikiforova, Marina N.</creatorcontrib><creatorcontrib>Bell, Phoenix D.</creatorcontrib><creatorcontrib>Paniccia, Alessandro</creatorcontrib><creatorcontrib>Zureikat, Amer H.</creatorcontrib><creatorcontrib>Gorantla, Vikram C.</creatorcontrib><creatorcontrib>Rhee, John C.</creatorcontrib><creatorcontrib>Thomas, Roby</creatorcontrib><creatorcontrib>Bartlett, David L.</creatorcontrib><creatorcontrib>Smith, Katelyn</creatorcontrib><creatorcontrib>Henn, Patrick</creatorcontrib><creatorcontrib>Theisen, Brian K.</creatorcontrib><creatorcontrib>Shyu, Susan</creatorcontrib><creatorcontrib>Shalaby, Akram</creatorcontrib><creatorcontrib>Choudry, M. Haroon A.</creatorcontrib><creatorcontrib>Singhi, Aatur D.</creatorcontrib><title>Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei)</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Appendiceal mucinous neoplasms (AMNs) with disseminated disease (pseudomyxoma peritonei) are heterogeneous tumors with variable clinicopathologic behavior. Despite the development of prognostic systems, objective biomarkers are needed to stratify patients. With the advent of next-generation sequencing (NGS), it remains unclear if molecular testing can improve the evaluation of disseminated AMN patients.
Methods
Targeted NGS was performed for 183 patients and correlated with clinicopathologic features to include American Joint Committee on Cancer/World Health Organization (AJCC/WHO) histologic grade, peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, and overall survival (OS).
Results
Genomic alterations were identified for 179 (98%) disseminated AMNs. Excluding mitogen-activated protein kinase genes and
GNAS
due to their ubiquitous nature, collective genomic alterations in
TP53
,
SMAD4
,
CDKN2A
, and the mTOR genes were associated with older mean age, higher AJCC/WHO histologic grade, lymphovascular invasion, perineural invasion, regional lymph node metastasis, and lower mean PCI (
p
< 0.040). Patients harboring
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or mTOR gene alterations were found to have lower OS rates of 55% at 5 years and 14% at 10 years, compared with 88% at 5 years and 88% at 10 years for patients without the aforementioned alterations (
p
< 0.001). Based on univariate and multivariate analyses, genomic alterations in
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or the mTOR genes in disseminated AMNs were a negative prognostic factor for OS and independent of AJCC/WHO histologic grade, PCI, CC score, and hyperthermic intraperitoneal chemotherapy treatment (
p
= 0.006).
Conclusions
Targeted NGS improves the prognostic assessment of patients with disseminated AMNs and identifies patients who may require increased surveillance and/or aggressive management.</description><subject>Chemotherapy</subject><subject>Genomics</subject><subject>Kinases</subject><subject>Lymph nodes</subject><subject>MAP kinase</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Next-generation sequencing</subject><subject>Oncology</subject><subject>p53 Protein</subject><subject>Smad4 protein</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>TOR protein</subject><subject>Translational Research</subject><subject>Tumors</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1TAQhSMEoqXwAiyQJTZlEfB_nGXVQlupwJUo68ixJ7euEjvYDvS-CM-Lb1NAYsFqRjPfnJnRqaqXBL8llIt3iWDOeI0pqwlrKKl3j6pDIkqJS0UelxxLVbdUioPqWUq3GJOGYfG0OmANI1xwclj9vNZxCxks-gR3uT4HD1FnFzz6At8W8Mb5Lbqc5hi-Q0L5BtAmhq0PKTuzcmFAm5KBzwn9cPkGnbmUYHJe71VP5hm8dQb0iD4uRS0sqawK86jTlNDxJsFiw7S7C5NGG4guBw_uzfPqyaDHBC8e4lH19cP769OL-urz-eXpyVVtGJW5BiYIV0q00OCmt7YZemF7INYao0FyMEJqRUBY2kqqGmo0lb0ksh0GRYlhR9XxqlseLO-m3E0uGRhH7aFc2lFFhcItpW1BX_-D3oYl-nJdoRouuWrknqIrZWJIKcLQzdFNOu46gru9a93qWldc6-5d63Zl6NWD9NJPYP-M_LapAGwFUmn5LcS_u_8j-wukc6av</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Wald, Abigail I.</creator><creator>Pingpank, James F.</creator><creator>Ongchin, Melanie</creator><creator>Hall, Lauren B.</creator><creator>Jones, Heather</creator><creator>Altpeter, Shannon</creator><creator>Liebdzinski, Michelle</creator><creator>Hamed, Ahmed B.</creator><creator>Derby, Joshua</creator><creator>Nikiforova, Marina N.</creator><creator>Bell, Phoenix D.</creator><creator>Paniccia, Alessandro</creator><creator>Zureikat, Amer H.</creator><creator>Gorantla, Vikram C.</creator><creator>Rhee, John C.</creator><creator>Thomas, Roby</creator><creator>Bartlett, David L.</creator><creator>Smith, Katelyn</creator><creator>Henn, Patrick</creator><creator>Theisen, Brian K.</creator><creator>Shyu, Susan</creator><creator>Shalaby, Akram</creator><creator>Choudry, M. Haroon A.</creator><creator>Singhi, Aatur D.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3930-7096</orcidid></search><sort><creationdate>20231101</creationdate><title>Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei)</title><author>Wald, Abigail I. ; Pingpank, James F. ; Ongchin, Melanie ; Hall, Lauren B. ; Jones, Heather ; Altpeter, Shannon ; Liebdzinski, Michelle ; Hamed, Ahmed B. ; Derby, Joshua ; Nikiforova, Marina N. ; Bell, Phoenix D. ; Paniccia, Alessandro ; Zureikat, Amer H. ; Gorantla, Vikram C. ; Rhee, John C. ; Thomas, Roby ; Bartlett, David L. ; Smith, Katelyn ; Henn, Patrick ; Theisen, Brian K. ; Shyu, Susan ; Shalaby, Akram ; Choudry, M. Haroon A. ; Singhi, Aatur D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-e35148859e707bdd7fb5dbe1ddccae64ec56a81e5d2962872ca26b6169ff821c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Chemotherapy</topic><topic>Genomics</topic><topic>Kinases</topic><topic>Lymph nodes</topic><topic>MAP kinase</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Next-generation sequencing</topic><topic>Oncology</topic><topic>p53 Protein</topic><topic>Smad4 protein</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>TOR protein</topic><topic>Translational Research</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wald, Abigail I.</creatorcontrib><creatorcontrib>Pingpank, James F.</creatorcontrib><creatorcontrib>Ongchin, Melanie</creatorcontrib><creatorcontrib>Hall, Lauren B.</creatorcontrib><creatorcontrib>Jones, Heather</creatorcontrib><creatorcontrib>Altpeter, Shannon</creatorcontrib><creatorcontrib>Liebdzinski, Michelle</creatorcontrib><creatorcontrib>Hamed, Ahmed B.</creatorcontrib><creatorcontrib>Derby, Joshua</creatorcontrib><creatorcontrib>Nikiforova, Marina N.</creatorcontrib><creatorcontrib>Bell, Phoenix D.</creatorcontrib><creatorcontrib>Paniccia, Alessandro</creatorcontrib><creatorcontrib>Zureikat, Amer H.</creatorcontrib><creatorcontrib>Gorantla, Vikram C.</creatorcontrib><creatorcontrib>Rhee, John C.</creatorcontrib><creatorcontrib>Thomas, Roby</creatorcontrib><creatorcontrib>Bartlett, David L.</creatorcontrib><creatorcontrib>Smith, Katelyn</creatorcontrib><creatorcontrib>Henn, Patrick</creatorcontrib><creatorcontrib>Theisen, Brian K.</creatorcontrib><creatorcontrib>Shyu, Susan</creatorcontrib><creatorcontrib>Shalaby, Akram</creatorcontrib><creatorcontrib>Choudry, M. Haroon A.</creatorcontrib><creatorcontrib>Singhi, Aatur D.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wald, Abigail I.</au><au>Pingpank, James F.</au><au>Ongchin, Melanie</au><au>Hall, Lauren B.</au><au>Jones, Heather</au><au>Altpeter, Shannon</au><au>Liebdzinski, Michelle</au><au>Hamed, Ahmed B.</au><au>Derby, Joshua</au><au>Nikiforova, Marina N.</au><au>Bell, Phoenix D.</au><au>Paniccia, Alessandro</au><au>Zureikat, Amer H.</au><au>Gorantla, Vikram C.</au><au>Rhee, John C.</au><au>Thomas, Roby</au><au>Bartlett, David L.</au><au>Smith, Katelyn</au><au>Henn, Patrick</au><au>Theisen, Brian K.</au><au>Shyu, Susan</au><au>Shalaby, Akram</au><au>Choudry, M. Haroon A.</au><au>Singhi, Aatur D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei)</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>30</volume><issue>12</issue><spage>7517</spage><epage>7526</epage><pages>7517-7526</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Appendiceal mucinous neoplasms (AMNs) with disseminated disease (pseudomyxoma peritonei) are heterogeneous tumors with variable clinicopathologic behavior. Despite the development of prognostic systems, objective biomarkers are needed to stratify patients. With the advent of next-generation sequencing (NGS), it remains unclear if molecular testing can improve the evaluation of disseminated AMN patients.
Methods
Targeted NGS was performed for 183 patients and correlated with clinicopathologic features to include American Joint Committee on Cancer/World Health Organization (AJCC/WHO) histologic grade, peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, and overall survival (OS).
Results
Genomic alterations were identified for 179 (98%) disseminated AMNs. Excluding mitogen-activated protein kinase genes and
GNAS
due to their ubiquitous nature, collective genomic alterations in
TP53
,
SMAD4
,
CDKN2A
, and the mTOR genes were associated with older mean age, higher AJCC/WHO histologic grade, lymphovascular invasion, perineural invasion, regional lymph node metastasis, and lower mean PCI (
p
< 0.040). Patients harboring
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or mTOR gene alterations were found to have lower OS rates of 55% at 5 years and 14% at 10 years, compared with 88% at 5 years and 88% at 10 years for patients without the aforementioned alterations (
p
< 0.001). Based on univariate and multivariate analyses, genomic alterations in
TP53
,
SMAD4
,
ATM
,
CDKN2A
, and/or the mTOR genes in disseminated AMNs were a negative prognostic factor for OS and independent of AJCC/WHO histologic grade, PCI, CC score, and hyperthermic intraperitoneal chemotherapy treatment (
p
= 0.006).
Conclusions
Targeted NGS improves the prognostic assessment of patients with disseminated AMNs and identifies patients who may require increased surveillance and/or aggressive management.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>37314541</pmid><doi>10.1245/s10434-023-13721-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3930-7096</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2023-11, Vol.30 (12), p.7517-7526 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2825809229 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Chemotherapy Genomics Kinases Lymph nodes MAP kinase Medicine Medicine & Public Health Metastases Next-generation sequencing Oncology p53 Protein Smad4 protein Surgery Surgical Oncology TOR protein Translational Research Tumors |
| title | Targeted Next-Generation Sequencing Improves the Prognostication of Patients with Disseminated Appendiceal Mucinous Neoplasms (Pseudomyxoma Peritonei) |
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