{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:14:36Z","timestamp":1792689276737,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mucinous appendiceal neoplasms with peritoneal dissemination (PD) show a wide spectrum of clinical behaviour. Histological grade has been correlated with prognosis, but no universally accepted histological grading has been established. The aim of this systematic review was to provide historical insight to understand current grading classifications, basic histopathological features of each category, and to define which classification correlates best with prognosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>MEDLINE and the Cochrane Library were searched for studies that reported survival across different pathological grades in patients with mucinous neoplasm of the appendix with PD treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. PRISMA guidelines were followed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-eight studies were included. Ronnett\u2019s classification was the most common (9 studies). Classifications proposed by the Peritoneal Surface Oncology Group International (PSOGI) (6 studies) and the seventh or eighth edition of the AJCC (7 studies) are gaining in popularity. Nine studies supported a two-tier, 12 a three-tier, and two a four-tier classification system. Three studies demonstrated that acellular mucin had a better prognosis than low-grade pseudomyxoma peritonei in the PSOGI classification or M1bG1 in the eighth edition of the AJCC classification. Four studies demonstrated that the presence of signet ring cells was associated with a worse outcome than high-grade pseudomyxoma peritonei in the PSOGI classification and M1bG2 in the eighth edition of the AJCC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>There is a great need for a common language in describing mucinous neoplasms of the appendix with PD. Evolution in terminology as a result of pathological insight turns the four-tiered PSOGI classification system into a coherent classification option.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrab059","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T11:07:06Z","timestamp":1622977626000},"source":"Crossref","is-referenced-by-count":7,"title":["Defining stage in mucinous tumours of the appendix with peritoneal dissemination: the importance of grading terminology: systematic review"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0423-910X","authenticated-orcid":false,"given":"L","family":"Mart\u00edn-Rom\u00e1n","sequence":"first","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Department of Surgery, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Lozano","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Department of Surgery, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"V\u00e1squez","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Department of Surgery, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Palencia","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M J","family":"Fern\u00e1ndez-Ace\u00f1ero","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2543-197X","authenticated-orcid":false,"given":"L","family":"Gonz\u00e1lez-Bay\u00f3n","sequence":"additional","affiliation":[{"name":"Peritoneal Carcinomatosis Unit, Department of General and Digestive Surgery, Hospital General Universitario Gregorio Mara\u00f1\u00f3n , Madrid, Spain"},{"name":"Department of Surgery, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"2022070814271202200_zrab059-B1","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1002\/cncr.10589","article-title":"Primary malignant neoplasms of the appendix: a population-based study from the surveillance, epidemiology and end-results program, 1973\u20131998","volume":"94","author":"McCusker","year":"2002","journal-title":"Cancer"},{"key":"2022070814271202200_zrab059-B2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/BF02236899","article-title":"Appendiceal tumors: retrospective clinicopathologic analysis of appendiceal tumors from 7970 appendectomies","volume":"41","author":"Connor","year":"1998","journal-title":"Dis Colon Rectum"},{"key":"2022070814271202200_zrab059-B3","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1245\/s10434-012-2238-1","article-title":"Importance of histologic subtype in the staging of appendiceal tumors","volume":"19","author":"Turaga","year":"2012","journal-title":"Ann Surg Oncol"},{"key":"2022070814271202200_zrab059-B4","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1007\/s10350-005-0196-4","article-title":"Malignancies of the appendix: beyond case series reports","volume":"48","author":"McGory","year":"2005","journal-title":"Dis Colon Rectum"},{"key":"2022070814271202200_zrab059-B5","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/00000658-199402000-00001","article-title":"Pseudomyxoma peritonei. 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