Appendectomy in primary and secondary staging operations for ovarian malignancy

Risk Factors for Appendiceal Metastasis with Epithelial Ovarian Cancer

“…Sonnendocker (1982), who was the first to demonstrate the high frequency of appendiceal involvement in epithelial ovarian cancers, reported an 83.3% metastatic rate in his small study of 12 stage III-IV patients. In subsequent reports by Malfetano (1987), Rose et al (1991) and Takac (2000), similar high rates were also reported in stage III-IV disease (69.7%, 69-75%, and 54.2%, respectively). However in patients with early-stage ovarian cancer, the appendix is rarely involved as evidenced by previous studies showing the rate of appendiceal metastasis in patients with early ovarian cancer to be ranged from 0-9% (4,9,10).…”

“…Mucinous ovarian tumor have been the least studied of ovarian tumors and prior appendectomy has been reported not to protect against developement of subsequent malignant mucinous ovarian tumor (Elias et al, 2013) There was no significant difference between appendiceal metastasis and histopathologic subtypes as Ayhan et al (2005) found in his study. However, Rose et al (1991) and Fontanelli et al (1992) had showed sinificantly more appendiceal involvement in patient with serous histopathology.…”

“…Our study deviates from the results of Bese and colleagues (1996) who observed no relationship between histological grade and metastasis to the appendix in their series. However, Rose et al (1991) concluded that, in comparison with grade I and II ovarian tumors, grade III tumors metastasize to the appendix more frequently.…”

Routine appendicectomy be performed as a part of surgical staging in ovarian cancer

“…This was in accordance with the studies conducted by Rose et al, Malfetano and Takac who reported similar high rates in stage III-IV disease (69.7%, 69-75% and 54.2% respectively). 1,5,6 Ayhan et al concluded that routine appendectomy is indicated in all cases of epithelial ovarian malignancy as part of the initial surgical staging procedure because of considerable rate of upstaging in early stage disease and optimal cyto reduction in advanced stages. 7 Our study shows significantly higher chance of involvement of appendix in whom omentum, lymphnode were positive for malignancy (O.R: 13.7, P: 0.002; O.R: 6.6, P: 0.002; respectively).…”

Isolated appendiceal metastasis in early ovarian carcinoma

“…Previous studies have shown a high incidence of appendiceal involvement in advanced stage III and IV disease [3,4]. Appendectomy at primary surgery may be useful in an advanced disease patient population if it contributes to tumor cytoreduction.…”