{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T07:03:21Z","timestamp":1789283001681,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2012,4,20]],"date-time":"2012-04-20T00:00:00Z","timestamp":1334880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,5,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low-grade appendiceal mucinous neoplasm (LAMN) is a precursor lesion for pseudomyxoma peritonei (PMP), which, if treated suboptimally, may later disseminate throughout the abdominal cavity. The role of cytoreductive surgery for these relatively early lesions is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinicopathological details and treatment outcomes of patients with a LAMN and disease limited to the appendix or immediate periappendiceal tissues, referred to a national treatment centre between 2002 and 2009, were evaluated prospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 379 patients with a diagnosis of PMP, 43 (median age 49 years) had LAMNs localized to the appendix and periappendiceal tissue. Thirty-two patients initially presented with symptoms of acute appendicitis or right iliac fossa pain. Two distinct lesions were identified: type I (disease confined to the appendiceal lumen) and type II (mucin and\/or neoplastic epithelium in the appendiceal submucosa, wall and\/or periappendiceal tissue, with or without perforation). Type I lesions were managed by a watch-and-wait surveillance policy with serial measurement of tumour markers and computed tomography in 14 of 16 patients. Seventeen of 27 patients with type II lesions underwent risk-reducing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with low morbidity. After a median follow-up of 40 months, there was no disease progression in either treatment pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study identified two LAMN subtypes. Type II lesions have pathological features of increased risk for dissemination and should be considered for risk-reducing cytoreductive surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.8739","type":"journal-article","created":{"date-parts":[[2012,4,20]],"date-time":"2012-04-20T05:41:11Z","timestamp":1334900471000},"page":"987-992","source":"Crossref","is-referenced-by-count":94,"title":["Classification of and cytoreductive surgery for low-grade appendiceal mucinous neoplasms"],"prefix":"10.1093","volume":"99","author":[{"given":"J R","family":"McDonald","sequence":"first","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S T","family":"O'Dwyer","sequence":"additional","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Rout","sequence":"additional","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Chakrabarty","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Sikand","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P E","family":"Fulford","sequence":"additional","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Wilson","sequence":"additional","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A G","family":"Renehan","sequence":"additional","affiliation":[{"name":"Peritoneal Tumour Service, Christie NHS Foundation Trust, Manchester, UK"},{"name":"School of Cancer and Enabling Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2012,4,20]]},"reference":[{"key":"2021031613302672500_bib1","first-page":"2134","volume-title":"Cancer Encyclopedia","author":"Renehan","year":"2009"},{"key":"2021031613302672500_bib2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.ejso.2007.04.002","article-title":"Appendiceal neoplasms and pseudomyxoma peritonei: a population based study","volume":"34","author":"Smeenk","year":"2008","journal-title":"Eur J Surg Oncol"},{"key":"2021031613302672500_bib3","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1002\/1097-0142(19901001)66:7<1636::AID-CNCR2820660731>3.0.CO;2-N","article-title":"The management of pseudomyxoma peritonei","volume":"66","author":"Mann","year":"1990","journal-title":"Cancer"},{"key":"2021031613302672500_bib4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1097\/PPO.0b013e3181a9c781","article-title":"Epithelial appendiceal neoplasms","volume":"15","author":"Sugarbaker","year":"2009","journal-title":"Cancer J"},{"key":"2021031613302672500_bib5","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1007\/BF02523654","article-title":"Pleural extension of mucinous tumor in patients with pseudomyxoma peritonei syndrome","volume":"7","author":"Pestieau","year":"2000","journal-title":"Ann Surg Oncol"},{"key":"2021031613302672500_bib6","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1038\/sj.bjc.6603398","article-title":"A specific cadherin phenotype may characterise the disseminating yet non-metastatic behaviour of pseudomyxoma peritonei","volume":"95","author":"Bibi","year":"2006","journal-title":"Br J Cancer"},{"key":"2021031613302672500_bib7","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.cell.2011.02.013","article-title":"Hallmarks of cancer: the next generation","volume":"144","author":"Hanahan","year":"2011","journal-title":"Cell"},{"key":"2021031613302672500_bib8","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1097\/00000478-199512000-00006","article-title":"Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. 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