{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:05:53Z","timestamp":1788447953719,"version":"build-2803163510"},"reference-count":62,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Appendiceal collision tumors (ACTs), defined by the coexistence of two or more histologically distinct neoplastic components within the appendix, are rare entities. We aimed to characterize their clinicopathologic features, management strategies, and outcomes by integrating an institutional case series with a systematic review of the literature. Methods: We retrospectively identified ACTs diagnosed at our institution and performed a PRISMA 2020-guided search of PubMed, Scopus, and Web of Science databases through May 2025 for case reports and case series. Two reviewers screened studies and extracted data on presentation, histologic composition, treatment, approaches and outcomes. Results: ACTs accounted for 4% of appendiceal tumors in our institution, all combining a neuroendocrine neoplasm (NEN) with a low-grade appendiceal mucinous neoplasm. The literature search identified 69 ACTs from 33 studies; pooled with our cases, 74 patients were evaluated. The most common pairings were NEN\u2013appendiceal mucinous neoplasm (53%) and NEN\u2013adenocarcinoma (26%), while three-component tumors were rare (n = 2). Early-stage tumors (pTis\u2013pT1) were uniformly managed with appendectomy or limited resection, in line with established stage-based management algorithms for appendiceal neoplasms. Advanced-stage tumors (pT3\u2013pT4) were treated according to the biologically dominant component, frequently with colectomy and, in high-risk mucinous disease, cytoreductive approaches. Across stages, outcomes appeared to be driven by the non-neuroendocrine component; a coexisting low-grade NEN did not independently confer worse prognosis. In ACTs with an adenocarcinoma component, goblet cell morphology was common, and outcomes appeared similar to those reported for non-collision appendiceal adenocarcinoma. Conclusions: ACTs represent a heterogeneous group in which prognosis is dictated by the non-neuroendocrine component and tumor stage. Low-grade NEN components appear biologically indolent, whereas adenocarcinoma and high-risk mucinous components have been observed to exhibit behavior similar to their solitary counterparts.<\/jats:p>","DOI":"10.3390\/diagnostics16010114","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T13:30:52Z","timestamp":1767187852000},"page":"114","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Appendiceal Collision Tumors: An Institutional Case Series and Systematic Review of the Histologic Spectrum, Clinical Outcomes, and Management Strategies"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3688-2768","authenticated-orcid":false,"given":"Gizem","family":"Issin","sequence":"first","affiliation":[{"name":"Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan 24100, Turkey"},{"name":"Department of Pathology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale 17020, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Pathology, Faculty of Medicine, Duzce University, Duzce 81620, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diren Vuslat","family":"Cagatay","sequence":"additional","affiliation":[{"name":"Department of Pathology, Erzincan Binali Yildirim University, Mengucek Gazi Training and Research Hospital, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-786X","authenticated-orcid":false,"given":"Irem","family":"Guvendir","sequence":"additional","affiliation":[{"name":"Department of Pathology, Health Science University Umraniye Training and Research Hospital, Istanbul 34764, Turkey"},{"name":"Department of Pathology, Health Science University, Lutfu Kirdar Training and Research Hospital, Istanbul 34865, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan Aktug","family":"Simsek","sequence":"additional","affiliation":[{"name":"Department of Pathology, Eskisehir City Hospital, Eskisehir 26080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itir Ebru","family":"Zemheri","sequence":"additional","affiliation":[{"name":"Department of Pathology, Health Science University Umraniye Training and Research Hospital, Istanbul 34764, Turkey"},{"name":"Department of Pathology, Istinye University, Istanbul 34396, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"ref_1","first-page":"265","article-title":"71,000 human appendix specimens. A final report, summarizing forty years study","volume":"14","author":"Collins","year":"1963","journal-title":"Am. J. Proctol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1136\/postgradmedj-2021-141244","article-title":"Retrospective analysis of the ap-pendiceal neoplasms: Sampling technique may influence neoplasm detection","volume":"99","author":"Issin","year":"2023","journal-title":"Postgrad. Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1002\/cncr.32793","article-title":"Continued increasing incidence of malignant appendiceal tumors in Canada and the United States: A population-based study","volume":"126","author":"Singh","year":"2020","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"zrac103","DOI":"10.1093\/bjsopen\/zrac103","article-title":"De-mographic trends in the incidence of malignant appendiceal tumours in England between 1995 and 2016: Population-based analysis","volume":"6","author":"Orchard","year":"2022","journal-title":"BJS Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1159\/000534347","article-title":"High incidence of appendiceal neoplasms in the elderly: A critical concern for non-surgical treatment","volume":"32","author":"Issin","year":"2023","journal-title":"Med. Princ. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/j.1365-2559.1995.tb00327.x","article-title":"Dual carcinoid\/epithelial neoplasia of the appendix","volume":"27","author":"Carr","year":"1995","journal-title":"Histopathology"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Viel, G., Ciarleglio, F.A., Frisini, M., Marcucci, S., Valcanover, S., Bragantini, E., Barbareschi, M., Mereu, L., Tateo, S., and Merola, E. (2023). Appendiceal collision tumors: Case reports, management and literature review. Front. Surg., 10.","DOI":"10.3389\/fsurg.2023.1184322"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1002\/1097-0142(195309)6:5<963::AID-CNCR2820060515>3.0.CO;2-Q","article-title":"Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin","volume":"6","author":"Slaughter","year":"1953","journal-title":"Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e14236","DOI":"10.1111\/dth.14236","article-title":"Collision tumors: A review of their types, pathogenesis, and diagnostic challenges","volume":"33","author":"Bulte","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e927876","DOI":"10.12659\/AJCR.927876","article-title":"A low-grade ap-pendiceal mucinous neoplasia and neuroendocrine appendiceal collision tumor: A case report and review of the literature","volume":"22","author":"Villa","year":"2021","journal-title":"Am. J. Case Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1097\/DCR.0000000000001530","article-title":"The American Society of Colon and Rectal Surgeons, clinical practice guidelines for the management of appendiceal neoplasms","volume":"62","author":"Glasgow","year":"2019","journal-title":"Dis. Colon. Rectum"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chicago Consensus Working Group (2020). The Chicago Consensus on peritoneal surface malignancies: Management of appendiceal neoplasms. Cancer, 126, 2525\u20132533.","DOI":"10.1002\/cncr.32881"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.pathol.2020.10.010","article-title":"The 2019 World Health Organization classification of appendiceal, colorectal and anal canal tumours: An update and critical assessment","volume":"53","author":"Ahadi","year":"2021","journal-title":"Pathology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.5858\/2000-124-1016-UPFTEO","article-title":"Updated protocol for the examination of specimens from patients with carcinomas of the colon and rectum, excluding carcinoid tumors, lymphomas, sarcomas, and tumors of the vermiform appendix: A basis for checklists","volume":"124","author":"Compton","year":"2000","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"102817","DOI":"10.1016\/j.labinv.2024.102817","article-title":"Appendiceal collision tumors: A multi-center case series of rare entities","volume":"105","author":"Durowoju","year":"2025","journal-title":"Lab. Invest."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s13691-025-00748-z","article-title":"Laparoscopically resected appendiceal dual tumor composed of goblet cell carcinoma and low-grade mucinous neoplasm: A case report and literature review","volume":"14","author":"Hirose","year":"2025","journal-title":"Int. Cancer Conf. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110547","DOI":"10.1016\/j.ijscr.2024.110547","article-title":"Collision tumor of the appendix with concomitant cecal adenocar-cinoma: A case report and literature review","volume":"125","author":"AlAwfi","year":"2024","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_18","first-page":"e38638","article-title":"Collision tumor of the appendix","volume":"15","author":"Flores","year":"2023","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"rjad281","DOI":"10.1093\/jscr\/rjad281","article-title":"Pseudomyxoma peritonei and an incidental low-grade appendiceal mucinous neoplasm and neuroendocrine appendiceal collision tumour: A case report","volume":"5","author":"Gupta","year":"2023","journal-title":"J. Surg. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"107260","DOI":"10.1016\/j.ijscr.2022.107260","article-title":"A unique case report of three morphologically distinct malignancies in an appendix specimen","volume":"95","author":"Rahman","year":"2022","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_21","first-page":"161","article-title":"Collision tumor of the appendix incidentally discovered in a patient diagnosed with an adenocarcinoma of the colon: A case report","volume":"43","author":"Moussa","year":"2022","journal-title":"Pan Afr. Med. J."},{"key":"ref_22","first-page":"1714","article-title":"A case of early appendiceal adenocarcinoma coexisting with high-grade appendiceal mucinous neoplasm","volume":"49","author":"Oka","year":"2022","journal-title":"Gan Kagaku Ryoho"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"307","DOI":"10.4236\/ojgas.2022.1210031","article-title":"Collision neoplasms of the vermiform appendix","volume":"12","author":"Melendez","year":"2022","journal-title":"Open J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"303","DOI":"10.47717\/turkjsurg.2021.3877","article-title":"Coexistence of low-grade mucinous neoplasm and carcinoid (collision tumor) within multiple appendiceal diverticula: A case report","volume":"37","author":"Ekinci","year":"2021","journal-title":"Turk. J. Surg."},{"key":"ref_25","first-page":"e17050","article-title":"The appendix: A rare case of an appendiceal collision tumor","volume":"13","author":"Ruiz","year":"2021","journal-title":"Cureus"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"113","DOI":"10.31053\/1853.0605.v77.n2.25071","article-title":"Tumor de colisi\u00f3n apendicular: Neoplasia epitelial mucinosa y tumor neuroendocrino","volume":"77","author":"Cafaro","year":"2020","journal-title":"Rev. Fac. Cien Med. Univ. Nac. Cordoba"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1177\/0003134820954847","article-title":"Triple Synchronous Tumors of the Appendix: Carcinoid, Goblet Cell Carcinoma and Low-Grade Mucinous Neoplasm","volume":"89","author":"Carboni","year":"2023","journal-title":"Am. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e229414","DOI":"10.1136\/bcr-2019-229414","article-title":"Management and outcome of an appendiceal collision tumour composed of neuroendocrine and mucinous neoplasms","volume":"12","author":"Sholi","year":"2019","journal-title":"BMJ Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"220","DOI":"10.5833\/jjgs.2017.0219","article-title":"An appendiceal goblet cell car-cinoid with a low-grade appendiceal mucinous neoplasm","volume":"52","author":"Chinen","year":"2019","journal-title":"Jpn. J. Gastroenterol. Surg."},{"key":"ref_30","first-page":"e3894","article-title":"Combined mucinous and neuroendocrine tumours of the ap-pendix managed with surgical cytoreduction and oxaliplatin-based hyperthermic intraperitoneal chem-otherapy","volume":"11","author":"Hajjar","year":"2019","journal-title":"Cureus"},{"key":"ref_31","first-page":"182","article-title":"Synchronous appendiceal triple primary neo-plasms and acute abdomen: A case report","volume":"8","author":"Yeh","year":"2018","journal-title":"J. Acute Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.ehpc.2018.07.005","article-title":"Combined goblet cell carcinoid and low-grade appendiceal mucinous neoplasm: A case report","volume":"14","author":"Sato","year":"2018","journal-title":"Hum. Pathol. Case Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ijscr.2017.09.007","article-title":"Two concurrent appendiceal neoplasms in an elderly patient: A case report","volume":"40","author":"Das","year":"2017","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ijscr.2020.01.022","article-title":"Synchronous primary neuroendocrine and mu-cinous epithelial tumors present in the same appendix: Case report of 2 patients","volume":"67","author":"Sugarbaker","year":"2020","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"bcr2015213938","DOI":"10.1136\/bcr-2015-213938","article-title":"Two rare cases of appendiceal collision tumours involving an appendiceal mucinous neoplasm and carcinoid","volume":"2016","author":"Tan","year":"2016","journal-title":"BMJ Case Rep."},{"key":"ref_36","first-page":"396","article-title":"Well differentiated neuroendocrine tumor of the appendix and low-grade appendiceal mucinous neo-plasm presenting as a collision tumor","volume":"107","author":"Otero","year":"2015","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/jso.23537","article-title":"Appendiceal goblet cell carcinoid and mucinous neoplasms are closely associated tumors: Lessons from their coexistence in primary tumors and concurrence in peritoneal dissemination","volume":"109","author":"Ng","year":"2014","journal-title":"J. Surg. Oncol."},{"key":"ref_38","first-page":"843","article-title":"Collision tumor of the appendix: Mucinous cystadenoma and carcinoid. A case report","volume":"109","author":"Dellaportas","year":"2014","journal-title":"Chirurgia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1159\/000324870","article-title":"Mixed adenocarcinoma-carcinoid (collision tumor) of the appendix","volume":"20","author":"Singh","year":"2011","journal-title":"Med. Princ. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1097\/PAS.0b013e3181e52916","article-title":"Combined classical carcinoid and goblet cell carcinoid tumor: A new morphologic variant of carcinoid tumor of the appendix","volume":"34","author":"Chetty","year":"2010","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3431","DOI":"10.3748\/wjg.15.3431","article-title":"Combined goblet cell carcinoid and mucinous cystadenoma of the ver-miform appendix","volume":"15","author":"Alsaad","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1097\/01.pas.0000128666.89191.48","article-title":"Primary mixed adenocarcinoma and small cell carcinoma of the appendix: A clinicopathologic, immunohistochemical, and molecular study of a hitherto unreported tumor","volume":"28","author":"Rossi","year":"2004","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1136\/jcp.48.9.869","article-title":"Combined goblet cell carcinoid and mucinous cystadenoma of the appendix","volume":"48","author":"Mason","year":"1995","journal-title":"J. Clin. Pathol."},{"key":"ref_44","first-page":"297","article-title":"Double tumours of the appendix: A rare entity. A case report","volume":"151","author":"Kornhall","year":"1985","journal-title":"Acta Chir. Scand."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/00000658-199401000-00009","article-title":"The natural history of surgically treated primary adenocarcinoma of the appendix","volume":"219","author":"Nitecki","year":"1994","journal-title":"Ann. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ijso.2016.06.003","article-title":"Primary adenocarcinoma of the appendix: Experience at La Paz University Hospital of Madrid (1967\u20132014)","volume":"4","author":"Arellano","year":"2016","journal-title":"Int J Surg Open"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"864","DOI":"10.5858\/134.6.864","article-title":"Appendiceal mucinous neoplasms: Controversial issues","volume":"134","author":"Misdraji","year":"2010","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/PAS.0000000000000535","article-title":"A consensus for classification and pathologic reporting of pseudomyxoma peritonei and associated appendiceal neoplasia: The results of the Peritoneal Surface Oncology Group International (PSOGI) modified Delphi process","volume":"40","author":"Carr","year":"2016","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1097\/PAS.0b013e31817f1816","article-title":"Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix","volume":"32","author":"Tang","year":"2008","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_50","first-page":"14","article-title":"Goblet cell carcinoid tumor of the appendix: An overview","volume":"23","author":"Reid","year":"2016","journal-title":"Adv. Anat. Pathol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Gironda, D.J., Erali, R.A., Forsythe, S.D., Pullikuth, A.K., Zheng-Pywell, R., Cummins, K.A., Soker, S., Gui, X., Levine, E.A., and Votanopoulos, K.I. (2025). The Genomic Topography of Appendiceal Cancers: Our Current Understanding, Clinical Perspectives, and Future Directions. Cancers, 17.","DOI":"10.3390\/cancers17193275"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.ejca.2023.03.024","article-title":"Molecular profiling and target actionability for precision medicine in neuroendocrine neoplasms: Real-world data","volume":"186","author":"Faron","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Mohamed, A., Wu, S., Hamid, M., Mahipal, A., Chakrabarti, S., Bajor, D., Selfridge, J.E., and Asa, S.L. (2022). Management of appendix neuroendocrine neoplasms: Insights on the current guidelines. Cancers, 15.","DOI":"10.3390\/cancers15010295"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1002\/jso.20179","article-title":"Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract","volume":"89","author":"Rorstad","year":"2005","journal-title":"J. Surg. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.jamcollsurg.2015.01.005","article-title":"Management of 1- to 2-cm carcinoid tumors of the appendix: Using the National Cancer Data Base to address contro-versies in general surgery","volume":"220","author":"Nussbaum","year":"2015","journal-title":"J. Am. Coll. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1159\/000461583","article-title":"ENETS consensus guidelines for the standards of care in neuro-endocrine tumors: Pre- and perioperative therapy in patients with neuroendocrine tumors","volume":"105","author":"Kaltsas","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s12020-019-02072-y","article-title":"The risk of lymph node metastases and their impact on survival in patients with appendiceal neuroendocrine neoplasms: A systematic review and meta-analysis of adult and paediatric patients","volume":"67","author":"Daskalakis","year":"2020","journal-title":"Endocrine"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/jso.21764","article-title":"Appendiceal carcinoid tumors: Predictors of lymph node metastasis and the impact of right hemicolectomy on survival","volume":"103","author":"Groth","year":"2011","journal-title":"J. Surg. Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1245\/s10434-017-6305-5","article-title":"Clinical surveillance after macroscopically complete surgery for low-grade appendiceal mucinous neoplasms (LAMN) with or without limited peritoneal spread: Long-term results in a prospective series","volume":"25","author":"Guaglio","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/01.sla.0000231705.40081.1a","article-title":"Survival analysis of pseudomyxoma peritonei patients treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy","volume":"245","author":"Smeenk","year":"2007","journal-title":"Ann. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13023-023-02995-w","article-title":"Hyperthermic intraperitoneal chemotherapy in patients with incomplete cytoreduction for appendiceal pseudomyxoma peritonei: A 10-year treatment experience in China","volume":"19","author":"Wang","year":"2024","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s11605-019-04239-4","article-title":"Outcomes following cy-toreduction and HIPEC for pseudomyxoma peritonei: 10-year experience","volume":"24","author":"Narasimhan","year":"2020","journal-title":"J. Gastrointest. Surg."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/114\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T13:47:56Z","timestamp":1767188876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/1\/114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":62,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["diagnostics16010114"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16010114","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,30]]}}}