Appendectomy Is Oncologically Equivalent to Right Hemicolectomy for Well-Differentiated T1 Appendiceal Adenocarcinoma

AlMasri, Samer; Hammad, Ahmed Mohammed Ali; Singhi, Aatur D.; Paniccia, Alessandro; Zureikat, Amer H.; Celebrezze, James; Choudry, Haroon A.; Nassour, Ibrahim

doi:10.1097/dcr.0000000000002089

Cited by 10 publications

(8 citation statements)

References 21 publications

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“…However, data suggest that for MAC with peritoneal seeding and low-risk ANOS (T1, low grade, no lymphovascular invasion) there is no survival advantage for including right hemicolectomy over appendicectomy or partial colectomy. 38 , 40 , 41 Our institution has a selective strategy for right hemicolectomy based on tumour grade, radiological findings and patient factors. This is appropriate, given the 21% rate of lymph node involvement in our current cohort is consistent with the literature.…”

Section: Discussionmentioning

confidence: 99%

Defining a role for systemic chemotherapy in local and advanced appendix adenocarcinoma

Strach,

Chakrabarty,

Nagaraju

et al. 2023

ESMO Open

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Section: Discussionmentioning

confidence: 99%

Defining a role for systemic chemotherapy in local and advanced appendix adenocarcinoma

Strach,

Chakrabarty,

Nagaraju

et al. 2023

ESMO Open

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“…Primary adenocarcinoma of the appendix is a rarely diagnosed malignancy, accounting for less than 6% of neoplastic lesions the appendix and less than 0.5% of all gastrointestinal malignancies. Like other appendicular neoplasms, they are most often an incidental finding after appendectomy (13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…It is often associated with synchronous and metachronous colorectal or extraintestinal cancer. According to the literature, surgical treatment is right hemicolectomy as a primary procedure in case of preoperative or intraoperative diagnosis or as a secondary procedure, two to three weeks after appendectomy, when microscopic examination of the preparation reveals the presence of adenocarcinoma (12,16).…”

Section: Discussionmentioning

confidence: 99%

Acute appendicitis without appendicitis

Daskalova,

Lavchev,

Rusenov

et al. 2023

SSM

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INTRODUCTION: A clinical, imaging, and laboratory constellation for acute appendicitis requires operative treatment to avoid life-threatening complications such as perforation and peritonitis. The latter, in turn, are an absolute indication for surgical intervention. Although it does not change the operative approach, in rare cases, the cause of the condition is appendicular diverticulitis-usually an incidental, pathological diagnosis with a literature frequency of 0.004-2.1%. The differential diagnosis of diverticula of the appendix in patients with acute appendicitis is important because of the higher risk of developing the above complications, but also because of primary neoplasms of the appendix. The latter are rare Tu with a frequency of 0.2-0.5% of all GIT neoplasms. Among them, carcinoids are the most common and are characterized by slow growth and a long asymptomatic course. However, they often present with the picture of acute appendicitis with/ without perforation, abscess or peritonitis. MATERIALS, METHODS AND RESULTS:The study was single-center, retrospective. Three patients with histologically verified appendicular diverticulitis with perforation and periappendicular abscess are presented, necessitating laparoscopic appendectomy (1 case), conventional appendectomy (1 case), right hemicolectomy (1 case). Adenocarcinoma of the appendix was proven in two patients with laparoscopic appendectomy.After verification of the permanent histological result and after discussion with the hospital Oncology Committee in the first case, the operation performed was determined to be sufficient in view of the oncological radicality. In the second case, reoperation with right hemicolectomy was recommended for histological evidence of T3 adenocarcinoma of the appendix. An appendicular mucocele was pathologically proven in one of the patients after laparoscopic appendectomy. CONCLUSION:The differential diagnosis of diverticulitis of the appendix in patients with acute appendicitis is important due to the higher risk of developing the above complications, but also because of primary neoplasms of the appendix. The latter are rare Tu with a frequency of 0.2-0.5% of all GIT neoplasms, which can also present with the picture of acute appendicitis with/without perforation, abscess or peritonitis.

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“…1 However, not all NMACAs are created equal. 2 In this timely study, Straker et al 3 used the National Cancer Database (NCDB) to identify a low-risk group of NMACAs for which less extensive surgical resection (i.e., appendectomy/partial colectomy [A/PC]) would be appropriate. They found that patients who had T1 tumors with good to moderate differentiation and no lymphovascular invasion (LVI) had a low risk of LN metastasis (1.8 %).…”

mentioning

confidence: 99%

“…The same has been observed for well-differentiated appendiceal neuroendocrine tumors, and most recently, for T1 welldifferentiated appendiceal adenocarcinomas, which require only a simple appendectomy. In the recent study, AlMasri et al 2 used the NCDB to examine the outcomes for patients who underwent appendectomy versus right colectomy for T1 (both mucinous and non-mucinous) appendix adenocarcinoma. They found that the OS was better when a right colectomy was performed for moderately or poorly differentiated tumors but not for well-differentiated tumors, similar to the findings of this study.…”

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confidence: 99%

Low-Risk Non-mucinous Adenocarcinoma of the Appendix: When Is an Appendectomy Enough?

Turner

Patel

2022

Ann Surg Oncol

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Non-metastatic adenocarcinoma of the appendix, often found incidentally after routine appendectomy, is a rare cancer whose subsequent management still is debated. It is classified into two general categories: mucinous and nonmucinous adenocarcinoma of the appendix (NMACA). The behavior of NMACA, considered similar to that of colon adenocarcinoma, exhibits more aggressive growth and has high rates of lymph node (LN) metastasis. 1 The management of NMACA involves performing a formal right hemicolectomy (RHC), not only to obtain a margin negative resection, but also to achieve optimal lymph node sampling for appropriate staging. 1 However, not all NMACAs are created equal. 2 In this timely study, Straker et al. 3 used the National Cancer Database (NCDB) to identify a low-risk group of NMACAs for which less extensive surgical resection (i.e., appendectomy/partial colectomy [A/PC]) would be appropriate. They found that patients who had T1 tumors with good to moderate differentiation and no lymphovascular invasion (LVI) had a low risk of LN metastasis (1.8 %). In contrast, positive LNs were found in roughly one fourth of all other patients. Examination of the entire patient cohort showed that RHC was associated with better overall survival (OS) than an A/PC. However, in the small group with DISCLOSURE There are no conflicts of interest.

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Appendectomy Is Oncologically Equivalent to Right Hemicolectomy for Well-Differentiated T1 Appendiceal Adenocarcinoma

Cited by 10 publications

References 21 publications

Defining a role for systemic chemotherapy in local and advanced appendix adenocarcinoma

Defining a role for systemic chemotherapy in local and advanced appendix adenocarcinoma

Acute appendicitis without appendicitis

Low-Risk Non-mucinous Adenocarcinoma of the Appendix: When Is an Appendectomy Enough?

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