Original ArticlesHistologic and Outcome Study Supports Reclassifying Appendiceal Goblet Cell Carcinoids as Goblet Cell Adenocarcinomas, and Grading and Staging Similarly to Colonic AdenocarcinomasYozu, Masato MD, PhD, FRCPA*; Johncilla, Melanie E. MD†; Srivastava, Amitabh MD‡; Ryan, David P. MD§; Cusack, James C. MD∥; Doyle, Leona MD‡; Setia, Namrata MD¶; Yang, Michelle MD, PhD#; Lauwers, Gregory Y. MD**; Odze, Robert D. MD, FRCPC‡; Misdraji, Joseph MD††Author Information Departments of ††Pathology ∥Surgery, Massachusetts General Hospital and Harvard Medical School ‡Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School §Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA *Histopathology Department, Middlemore Hospital, Auckland, New Zealand **Department of Pathology, H. Lee Moffitt Cancer Center, Tampa, FL #Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT ¶Department of Pathology, University of Chicago, Chicago IL †Department of Pathology, Weill Cornell Medicine, New York, NY This work was conducted with support from Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University, and its affiliated academic health care centers, or the National Institutes of Health. Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Joseph Misdraji, MD, Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 (e-mail: [email protected]). The American Journal of Surgical Pathology: July 2018 - Volume 42 - Issue 7 - p 898-910 doi: 10.1097/PAS.0000000000001056 Buy Metrics Abstract Goblet cell carcinoid tumors are amphicrine tumors whose biological behavior ranges from indolent to highly aggressive, depending on tumor grade. Current grading systems for these tumors are based on identifying an adenocarcinoma arising in the setting of a goblet cell carcinoid tumor, which distinguishes this tumor from other gastrointestinal tract adenocarcinomas. Because goblet cell tumors are predominantly tumors of mucin secreting cells, we propose that they be classified as goblet cell adenocarcinomas, and graded using a methodology that has parallels in colorectal adenocarcinoma grading. We graded a large series of goblet cell adenocarcinomas by assessing the proportion of the tumor that demonstrates tubular or clustered growth. Histologic grade correlated with overall survival independent of stage, with median overall survival of 204, 86, and 29 months for low-grade, intermediate-grade, and high-grade goblet cell adenocarcinomas, respectively. Tumor stage also correlated with overall survival. We also graded the tumors according to previously proposed grading systems, and found that these systems are valid, in that they segregate patients according to prognosis. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.