Surgical Management of Appendix Tumors: a Single-Center Review of 15 Years

İngilizce (OpenAlex)

Objective: Primary neoplasms of the appendix are rare and most clinicians are unfamiliar with them. The selected approach may differ, ranging from appendectomy to cytoreductive surgery. We aimed to present our clinical experience with the surgical management of appendix tumors. Materials and Methods: 4,450 patients with a history of appendectomy from January 2006 to February 2021 were analyzed retrospectively. Patients diagnosed with “serrated lesion/polyp, low/high-grade appendiceal mucinous neoplasm (LAMN/ HAMN), mucinous/non-mucinous/goblet cell adenocarcinoma, neuroendocrine tumor (NET)” were included in the study. Histological evaluations, surgical procedures, follow-up data, and survival outcomes were evaluated. Results: Among 132 [F:87 (65.9%)] patients diagnosed with appendix tumors, 27 (20.5%) were in the benign group (Group A), 61 (46.2%) were in the borderline group (Group B), and 44 (33.3%) were in the malignant group (Group C). Appendectomy and right hemicolectomy were performed as the initial operations in 105 (79.5%) and 27 (20.5%) patients, respectively. Seventeen patients (12.9%) with a previous history of appendectomy received right hemicolectomy (n=9; due to surgical margin positivity) and Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) (n=8; due to recurrence) as redo surgery during the follow-up period. Appendectomy was sufficient for 88 (66.6%) patients. Adenocarcinoma was revealed as a statistically significant factor for recurrence-free survival (RFS) (HR=7.28, p=0.049). Malignancy (HR=3.76, p=0.036) and age (≥60) (HR=3.86, p=0.006) were significant factors of overall survival (OS). Conclusion: Appendectomy is efficient in the treatment of appendix tumors for selected cases considering low morbidity of the procedure and favorable survival outcomes. For advanced-stage tumors, extended resections combined with chemotherapy should be the preferred approach.